Johnnie L Puccio PTA, LMT

NPI 1083906366 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1083906366
Gender Female
Enumeration Date 05/05/2011
Last Updated 05/05/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
2129 W NEW HAVEN AVE
W MELBOURNE FL, 32904-3875, US
Phone (321) 723-8299
Fax
Business Location
2560 QUARRY AVE SE
PALM BAY FL, 32909-7270, US
Phone (321) 676-4816
Fax
Toxanomy
Taxonomy Code 225200000X
License State Florida
License Number PTA19316
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According to our database, Mrs. Johnnie L Puccio PTA, LMT NPI is 1083906366, taxonomy code is 225200000X and license number is PTA19316, license state is located at Florida. Johnnie L Puccio PTA, LMT physically located at 2129 W New Haven Ave, W Melbourne FL, 32904-3875. NPI Number Johnnie L Puccio PTA, LMT has the Individual type.

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1083906366 NPI number is provided on an as is basis without warranty of any kind. 1083906366 is maintained by the National Plan & Provider Enumeration System. The contents of Johnnie L Puccio PTA, LMT are for informational purposes only.