Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Crystal Wallace Goddin, PTA

Individual provider Physical Therapy Assistant · NPI 1619465481

Crystal Wallace Goddin, PTA is a Physical Therapy Assistant in Bushnell, Florida. Licensed in Florida. Registered with an NPI since 2018.

Licensed in
FL
In the registry since
2018
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

1104 N Main St Bushnell Fl
Bushnell, FL 33513
Phone: (352) 568-8777
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 23675 (FL)

Record details

NPI number1619465481
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedApril 27, 2018
Last updated in NPPESApril 27, 2018
Mailing address391 Cr 549, Bushnell, FL 33513

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