Provider Demographics
NPI:1114277233
Name:RHODES, CLAIRE LOUISE (PT)
Entity Type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:LOUISE
Last Name:RHODES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-1906
Mailing Address - Country:US
Mailing Address - Phone:850-630-1508
Mailing Address - Fax:
Practice Address - Street 1:2316 W 23RD ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-2345
Practice Address - Country:US
Practice Address - Phone:850-522-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13658225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist