Johnnie L Puccio, PTA, LMT
Physical Therapy Assistant in W Melbourne, FL. Individual provider (NPI-1).
NPI number1083906366
StatusActive
Last updated in NPPESMay 5, 2011
Details
- NPI
- 1083906366
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Johnnie L Puccio
- Credential
- PTA, LMT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 5, 2011
- Last updated
- May 5, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | PTA19316 | FL | Yes |
Practice location
2129 W New Haven AveW Melbourne, FL 32904-3875
Phone 321-723-8299
Mailing address
2560 Quarry Ave SePalm Bay, FL 32909-7270
Phone 321-676-4816
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