Shelley Ankerholz, PTA

Individual provider Active NPI Physical Therapy Assistant · Lake Mary, FL

NPI 1639624695 · NPPES record last updated Aug 19, 2016

Key facts

NPI
1639624695
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA26801 (FL)
Practice address
934 Williston Park PT Ste 1020
Lake Mary, FL 32746-2165
Phone
(407) 829-7311
NPI assigned
Aug 19, 2016
Sex
Female
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
PTA26801FLMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA26801 FL Yes

Addresses

Primary practice location

934 Williston Park PT Ste 1020
Lake Mary, FL 32746-2165

Mailing address

1452 Foxtail CT
Lake Mary, FL 32746-4467
Phone (407) 463-1133

Other providers in Lake Mary, FL

All providers in Lake Mary, FL · Physical Therapy Assistant in Florida

Sources for this page

Verify at the official NPI Registry.