Macey Faith Hardee
Individual provider Active NPI Physical Therapy Assistant · Lawtey, FL
NPI 1962078774 · NPPES record last updated Jun 2, 2021
Key facts
- NPI
- 1962078774
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA30858 (FL)
- Practice address
- 1104 NW 265TH St
Lawtey, FL 32058 - Phone
- (904) 769-0564
- NPI assigned
- Jun 2, 2021
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| PTA30858 | FL | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA30858 | FL | Yes |
Addresses
Primary practice location
1104 NW 265TH St
Lawtey, FL 32058
Mailing address
1104 NW 265TH St
Lawtey, FL 32058
Phone (904) 769-0564
Other providers in Lawtey, FL
- Turosia Evette Bright
- CT Counseling LLC
- Laura Ashley Griffis
- Guardian Angel Personal Care Service LLC
- Ryan Hendrieth
- Nikita L Jenkins
- Mernies Counseling LLC
- Slocum'S Adult Family Care LLC
- Christina Tatum
All providers in Lawtey, 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 Jun 2, 2021. 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.