Provider Demographics
NPI:1982957692
Name:JOSEPH, TEENA THOMAS (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:TEENA
Middle Name:THOMAS
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MRS
Other - First Name:TEENA
Other - Middle Name:ACHAMMA
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1331 WINDING RIDGE DR
Mailing Address - Street 2:APT # 2A
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439
Mailing Address - Country:US
Mailing Address - Phone:810-813-0366
Mailing Address - Fax:
Practice Address - Street 1:2916 HABANA WAY
Practice Address - Street 2:HABANA HEALTH AND REHAB
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614
Practice Address - Country:US
Practice Address - Phone:866-309-0069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 27409225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist