Carleton Lloyd Weidemeyer

Individual provider Active NPI Physical Therapy Assistant · Spring Hill, FL

NPI 1255001038 · NPPES record last updated Sep 14, 2021

Key facts

NPI
1255001038
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA31448 (FL)
Practice address
7045 Evergreen Woods TRL
Spring Hill, FL 34608-1306
Phone
(727) 614-1431
NPI assigned
Sep 14, 2021
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA31448FLMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA31448 FL Yes

Addresses

Primary practice location

7045 Evergreen Woods TRL
Spring Hill, FL 34608-1306

Mailing address

5407 Panama Ave
Spring Hill, FL 34609-1336
Phone (727) 614-1431

Other providers in Spring Hill, FL

All providers in Spring Hill, FL · Physical Therapy Assistant in Florida

Sources for this page

Verify at the official NPI Registry.