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NPI Code Detail

MEDICARE: ERIC WHEELER DPT

MEDICARE: ERIC WHEELER DPT
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
1225100000XPhysical TherapistPT35314FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841835089
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC WHEELER DPT
Provider Business Mailing Address
First Line : 96279 BRADY POINT RD STE B
Second Line :
City : FERNANDINA BEACH
State : FL
Zip : 32034-7076
Country : US
Telephone Number : 904-261-7878
Fax Number : 904-261-8466
Provider Business Practice Location Address
First Line : 96279 BRADY POINT RD STE B
Second Line :
City : FERNANDINA BEACH
State : FL
Zip : 32034-7076
Country : US
Telephone Number : 904-261-7878
Fax Number : 904-261-8466
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2019
Last Update Date : 11/12/2019

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