MEDICARE: MARY DUCOTE

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
1	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1568011351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY DUCOTE

Provider Business Mailing Address
First Line	:	74 CLEVELAND RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-3814
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	74 CLEVELAND RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-3814
Country	:	US
Telephone Number	:	561-310-4424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2019
Last Update Date	:	09/05/2019

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Directions to “ MARY DUCOTE ” Practice Location

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