Provider Demographics
NPI:1922290691
Name:LAND, CECILIA K (PT)
Entity Type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:K
Last Name:LAND
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:212 WAYNESBORO WAY
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-6344
Mailing Address - Country:US
Mailing Address - Phone:334-702-1468
Mailing Address - Fax:334-712-3553
Practice Address - Street 1:1108 ROSS CLARK CIR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3022
Practice Address - Country:US
Practice Address - Phone:334-793-8719
Practice Address - Fax:334-712-3553
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALPTH1614225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist