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NPI Code Detail

MEDICARE: ALLISON LEIGH MCDANIEL PTA

MEDICARE: ALLISON LEIGH MCDANIEL 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 AssistantPTA21303FL

General Provider Information

NPI Number : 1528203304
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON LEIGH MCDANIEL PTA
Provider Business Mailing Address
First Line : 1100 OAKBRIDGE PKWY
Second Line : APT 153
City : LAKELAND
State : FL
Zip : 33803-5996
Country : US
Telephone Number : 386-846-1080
Fax Number :
Provider Business Practice Location Address
First Line : 3127 US HIGHWAY 98 N
Second Line :
City : LAKELAND
State : FL
Zip : 33805-2103
Country : US
Telephone Number : 863-665-8881
Fax Number : 863-665-8851
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2008
Last Update Date : 12/09/2008

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Directions to “ ALLISON LEIGH MCDANIEL PTA” Practice Location

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