Clinton Kincannon
Individual provider Active NPI Physical Therapy Assistant · Oxford, FL
NPI 1134925829 · NPPES record last updated Feb 22, 2025
Key facts
- NPI
- 1134925829
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA29228 (FL)
- Practice address
- 12120 County Road 103
Oxford, FL 34484-2987 - Phone
- (352) 571-5554
- NPI assigned
- Feb 22, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA29228 | FL | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trinity Therapy FL, LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA29228 | FL | Yes |
Addresses
Primary practice location
12120 County Road 103
Oxford, FL 34484-2987
Mailing address
PO Box 61
Oxford, FL 34484-0061
Phone (352) 571-5554
Other providers in Oxford, FL
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- Sharon Kimberley Kelton Durrance
- Katherine Elizabeth Kennedy
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- Kristen Ashley Leblanc
- Rania Livada
- Amanda Sharron Lober
- Lowell F Clark MD PA
All providers in Oxford, FL · Physical Therapy Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.