Provider Demographics
NPI:1699897033
Name:VODNANSKY, MARGARET ADINE (PT)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ADINE
Last Name:VODNANSKY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 NW SPRING HOLLOW BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32055-8165
Mailing Address - Country:US
Mailing Address - Phone:386-752-3211
Mailing Address - Fax:386-752-2710
Practice Address - Street 1:490 NW SPRING HOLLOW BLVD
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-8165
Practice Address - Country:US
Practice Address - Phone:386-752-3211
Practice Address - Fax:386-752-2710
Is Sole Proprietor?:No
Enumeration Date:2007-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT2587225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist