MEDICARE: MS. MICHELLE A RICE MSPT

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	225100000X	Physical Therapist	PT18312	FL
2	261QP2000X	Physical Therapy Clinic/Center	PT18312	FL

General Provider Information

NPI Number	:	1710297833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE A RICE MSPT

Provider Business Mailing Address
First Line	:	PO BOX 7663
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33872-0112
Country	:	US
Telephone Number	:	863-658-1797
Fax Number	:	863-385-0508

Provider Business Practice Location Address
First Line	:	931 MALL RING RD
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33870-8515
Country	:	US
Telephone Number	:	863-658-1797
Fax Number	:	863-385-0508

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

Provider Enumeration Date	:	10/08/2010
Last Update Date	:	12/31/2015

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