Most Relevant Information
Provider Data
| NPI Number: | 1003400946 |
| Provider Name: | TABITHA BAXTER PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/22/2021 |
| Last Updated: | 02/22/2021 |
Provider Practice Location
201 PARK PLACE BLVD
KISSIMMEE
FL
347412345
Practice Location Phone/Fax
| Phone: | 3219728326 |
| Fax: |
Provider Mailing Location
201 PARK PLACE BLVD
KISSIMMEE
FL
347412345
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |