Taiesha Shakima Lide, PTA
Physical Therapy Assistant in Boynton Beach, FL. Individual provider (NPI-1).
NPI number1114596194
StatusActive
Last updated in NPPESJun 23, 2021
Details
- NPI
- 1114596194
- Entity type
- Individual (NPI-1)
- Name
- Taiesha Shakima Lide
- Credential
- PTA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 23, 2021
- Certification date
- Jun 23, 2021
- Last updated
- Jun 23, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | PTA31003 | FL | Yes |
Practice location
6609 W Woolbright Rd Ste 420Boynton Beach, FL 33437-0917
Phone 561-200-4262 · Fax 561-200-4268
Mailing address
6609 W Woolbright Rd Ste 420Boynton Beach, FL 33437-0917
Phone 561-200-4262 · Fax 561-200-4268
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All 49 Physical Therapy Assistant providers in Boynton Beach · All 4,632 providers in Boynton Beach
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