Provider Demographics
NPI:1720307309
Name:DUNCAN, PRISCILLA DIANE (DPT)
Entity Type:Individual
Prefix:DR
First Name:PRISCILLA
Middle Name:DIANE
Last Name:DUNCAN
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 1:55 BANNBURY LN
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-8849
Mailing Address - Country:US
Mailing Address - Phone:386-986-4121
Mailing Address - Fax:
Practice Address - Street 1:55 BANNBURY LN
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-8849
Practice Address - Country:US
Practice Address - Phone:386-986-4121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-22
Last Update Date:2010-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24757225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist