Matthew Billups

Individual provider Active NPI Physical Therapy Assistant · Bartow, FL

NPI 1306207634 · NPPES record last updated Mar 15, 2016

Key facts

NPI
1306207634
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA25908 (FL)
Practice address
1575 N Tate Ave
Bartow, FL 33830-3160
Phone
(863) 904-7600
NPI assigned
Mar 15, 2016
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
PTA25908FLMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA25908 FL Yes

Addresses

Primary practice location

1575 N Tate Ave
Bartow, FL 33830-3160

Mailing address

1575 N Tate Ave
Bartow, FL 33830-3160
Phone (863) 904-7600

Other providers in Bartow, FL

All providers in Bartow, FL · Physical Therapy Assistant in Florida

Sources for this page

Verify at the official NPI Registry.