Provider Demographics
NPI:1952441784
Name:HUNT, TERESA K (PTA)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:K
Last Name:HUNT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MS
Other - First Name:TERESA
Other - Middle Name:K
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:1016 W GAUCHO CIR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-6938
Mailing Address - Country:US
Mailing Address - Phone:386-574-1934
Mailing Address - Fax:
Practice Address - Street 1:1119 SAXON BLVD
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8470
Practice Address - Country:US
Practice Address - Phone:386-774-4404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 20401225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant