Provider Demographics
NPI:1538392287
Name:POPPELL, JAMES EARL JR (MSPT)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EARL
Last Name:POPPELL
Suffix:JR
Gender:M
Credentials:MSPT
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Mailing Address - Street 1:220 N SYKES CREEK PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-3490
Mailing Address - Country:US
Mailing Address - Phone:321-459-0303
Mailing Address - Fax:321-452-0982
Practice Address - Street 1:220 N SYKES CREEK PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-3490
Practice Address - Country:US
Practice Address - Phone:321-459-0303
Practice Address - Fax:321-452-0982
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPT18845225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist