Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
May 14, 2007
License(s)
PT21968 (FL), QA001090900 (NJ)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 3903 SOUTH CHICKISAW TRAIL | Orlando, FL 32829 | 407-859-6374 |
| LOCATION | 3903 S CHICKASAW TRL | Orlando, FL 32829-8603 | 407-859-6374 |
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