Provider Demographics
NPI:1306397740
Name:WEST MCCABE, ADDISON WHITNEY (DPT)
Entity Type:Individual
Prefix:
First Name:ADDISON
Middle Name:WHITNEY
Last Name:WEST MCCABE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6015 POINTE WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-5525
Mailing Address - Country:US
Mailing Address - Phone:417-588-5625
Mailing Address - Fax:
Practice Address - Street 1:5101 4TH AVENUE CIR E
Practice Address - Street 2:500
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-5630
Practice Address - Country:US
Practice Address - Phone:941-792-1404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 31706225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist