Stacey Yearian PTA

NPI 1790879161 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1790879161
Gender Female
Enumeration Date 10/03/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
540 KINGSLEY AVE
ORANGE PARK FL, 32073-4847, US
Phone (904) 264-2156
Fax
Business Location
7704 FAWN LAKE DR S
JACKSONVILLE FL, 32256-3692, US
Phone (904) 288-9577
Fax
Toxanomy
Taxonomy Code 225200000X
License State Florida
License Number PTA20062
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According to our database, Stacey Yearian PTA NPI is 1790879161, taxonomy code is 225200000X and license number is PTA20062, license state is located at Florida. Stacey Yearian PTA physically located at 540 Kingsley Ave, Orange Park FL, 32073-4847. NPI Number Stacey Yearian PTA has the Individual type.

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1790879161 NPI number is provided on an as is basis without warranty of any kind. 1790879161 is maintained by the National Plan & Provider Enumeration System. The contents of Stacey Yearian PTA are for informational purposes only.