Doctor Name: | MS. MICHELLE BLACKWELL LONG |
NPI Number: | 1356663991 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. |
License Number: | PT0025201 |
Business Practice Address: | 4406 S Florida Ave Suite #16 Lakeland, FL - 338132172 |
Business Phone Number: | 8636881800 |
Business Fax Number: | 8636881824 |
Mailing Address: | 4406 S Florida Ave, Suite #16 LAKELAND |
State: | FL |
Postal Code: | 338132172 |
Phone Number: | 8636881800 |
Fax Number: | 8636881824 |
NPI Enumeration Date: | 02/24/2010 |
NPI Last Update Date: | 02/24/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT0025201 |
Healthcare Provider Taxonomy: (Secondary) | Y |
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 |