Provider Demographics
NPI:1407151202
Name:STRICKLAND, BETHANY ELAINE (PTA)
Entity Type:Individual
Prefix:MISS
First Name:BETHANY
Middle Name:ELAINE
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3227 OAK TREE LN
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-1329
Mailing Address - Country:US
Mailing Address - Phone:863-875-3635
Mailing Address - Fax:
Practice Address - Street 1:701 OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-1671
Practice Address - Country:US
Practice Address - Phone:863-318-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA21896225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant