Provider Demographics
NPI:1447382544
Name:KILLIAN, ARTHUR GEORGE JR (MSPT, MAS)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:GEORGE
Last Name:KILLIAN
Suffix:JR
Gender:M
Credentials:MSPT, MAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6131 IBISPARK DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-3909
Mailing Address - Country:US
Mailing Address - Phone:813-655-8822
Mailing Address - Fax:813-655-8823
Practice Address - Street 1:6131 IBISPARK DR
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-3909
Practice Address - Country:US
Practice Address - Phone:813-655-8822
Practice Address - Fax:813-655-8823
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21577225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist