Most Relevant Information
Provider Data
| NPI Number: | 1003402306 |
| Provider Name: | JAN PASOUR PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 19266 |
Most Important Dates
| Enumeration Date: | 12/21/2020 |
| Last Updated: | 12/21/2020 |
Provider Practice Location
6513 COLONADE CIR
PENSACOLA
FL
325063913
Practice Location Phone/Fax
| Phone: | 8503808706 |
| Fax: |
Provider Mailing Location
6513 COLONADE CIR
PENSACOLA
FL
325063913
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |