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NPI Code Detail

MEDICARE: DONNA MARIE CLOVER PTA

MEDICARE: DONNA MARIE CLOVER PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantPTA2470
2225200000XPhysical Therapy Assistant
3225200000XPhysical Therapy Assistant4882TN
4225200000XPhysical Therapy Assistant116620MO
5225200000XPhysical Therapy AssistantPTA22483FL

General Provider Information

NPI Number : 1376742668
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA MARIE CLOVER PTA
Provider Business Mailing Address
First Line : 5100 CRESTHAVEN BLVD
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33415-8618
Country : US
Telephone Number : 561-964-2828
Fax Number :
Provider Business Practice Location Address
First Line : 5100 CRESTHAVEN BLVD
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33415-8618
Country : US
Telephone Number : 561-964-2829
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2007
Last Update Date : 04/06/2018

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