Doctor Name: | MISS KATHLEEN SISON AZCONA |
NPI Number: | 1124289954 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 24432 |
Business Practice Address: | 11197 Sw Springtree Ter Port Saint Lucie, FL - 349872733 |
Business Phone Number: | 7032202476 |
Business Fax Number: | |
Mailing Address: | 11197 Sw Springtree Ter, PORT SAINT LUCIE |
State: | FL |
Postal Code: | 349872733 |
Phone Number: | 7032202476 |
Fax Number: | |
NPI Enumeration Date: | 06/24/2008 |
NPI Last Update Date: | 08/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 24432 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |