Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Dec 13, 2024
License(s)
PT42459 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 21756 STATE ROAD 54 STE 102 | Lutz, FL 33549-2905 | |
| LOCATION | 2600 DR MARTIN LUTHER KING JR ST N STE 200B | St Petersburg, FL 33704-2744 | 727-202-4625 |
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