MEDICARE: MRS. TERESA K HUNT 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
1	225200000X	Physical Therapy Assistant	PTA 20401	FL

General Provider Information

NPI Number	:	1952441784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TERESA K HUNT PTA

Provider Business Mailing Address
First Line	:	1016 W GAUCHO CIR
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32725-6938
Country	:	US
Telephone Number	:	386-574-1934
Fax Number	:

Provider Business Practice Location Address
First Line	:	1119 SAXON BLVD
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8470
Country	:	US
Telephone Number	:	386-774-4404
Fax Number	:

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

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	07/08/2007

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