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NPI Code Detail

MEDICARE: LYNNE GATES HOUSE P.T.

MEDICARE: LYNNE GATES HOUSE P.T.
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
12251X0800XOrthopedic Physical TherapistPT4331FL

General Provider Information

NPI Number : 1962423673
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNNE GATES HOUSE P.T.
Provider Business Mailing Address
First Line : 2120 SEMINOLE SHORES LN
Second Line :
City : VERO BEACH
State : FL
Zip : 32963-3125
Country : US
Telephone Number : 772-231-1258
Fax Number :
Provider Business Practice Location Address
First Line : 1705 17TH AVE
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-3641
Country : US
Telephone Number : 772-562-6877
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 07/08/2007

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Directions to “ LYNNE GATES HOUSE P.T.” Practice Location

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