Provider Demographics
NPI:1033360987
Name:ELKINS, MARIE CASWELL (LMT, LPTA)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:CASWELL
Last Name:ELKINS
Suffix:
Gender:F
Credentials:LMT, LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5804 DEER TRACKS TRL
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33811-2080
Mailing Address - Country:US
Mailing Address - Phone:863-604-5784
Mailing Address - Fax:863-644-8334
Practice Address - Street 1:4415 FLORIDA NATIONAL DR
Practice Address - Street 2:SUITE 110
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-1563
Practice Address - Country:US
Practice Address - Phone:863-604-5784
Practice Address - Fax:863-644-8334
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPTA14057225200000X
FLMA34342225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant