Charity Lynn Avera

Individual provider Active NPI Physical Therapy Assistant · Crawfordville, FL

NPI 1801301593 · NPPES record last updated Dec 4, 2017

Key facts

NPI
1801301593
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
18983 (FL)
Practice address
327 Emmett Whaley Rd
Crawfordville, FL 32327-4075
Phone
(850) 768-0544
Fax
(850) 768-0544
NPI assigned
Dec 4, 2017
Sex
Female
Sole proprietor
Yes

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
18983FLMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 18983 FL Yes

Addresses

Primary practice location

327 Emmett Whaley Rd
Crawfordville, FL 32327-4075

Mailing address

327 Emmett Whaley Rd
Crawfordville, FL 32327-4075
Phone (850) 768-0544

Other providers in Crawfordville, FL

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

Sources for this page

Verify at the official NPI Registry.