Doctor Name: | DEBRA C REARDON |
NPI Number: | 1891886750 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. |
License Number: | PT0005406 |
Business Practice Address: | 4406 S Florida Ave Suite 16 Lakeland, FL - 338132172 |
Business Phone Number: | 8636480099 |
Business Fax Number: | 8637099740 |
Mailing Address: | 4406 S Florida Ave, Suite 16 LAKELAND |
State: | FL |
Postal Code: | 338132172 |
Phone Number: | 8636480099 |
Fax Number: | 8637099740 |
NPI Enumeration Date: | 09/27/2006 |
NPI Last Update Date: | 04/03/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT0005406 |
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 |