Lymphedema Treatment Center LLC
Occupational Therapist in Jacksonville, FL. Organization (NPI-2).
NPI number1609045756
StatusActive
Last updated in NPPESFeb 22, 2008
Details
- NPI
- 1609045756
- Entity type
- Organization (NPI-2)
- Legal business name
- Lymphedema Treatment Center LLC
- Organization subpart
- No
- Enumeration date
- Feb 22, 2008
- Last updated
- Feb 22, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | OT12323 | FL | Yes |
Practice location
11512 Lake Mead Ave Unit 604Jacksonville, FL 32256-9686
Phone 904-425-4391 · Fax 904-425-4392
Mailing address
11512 Lake Mead Ave Unit 604Jacksonville, FL 32256-9686
Phone 904-425-4391 · Fax 904-425-4392
Authorized official
Rose Marsha Corrales
Owner/ Therapist
9044254391
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