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1184066771
JOHNNETHEL M FORT
JACKSONVILLE, FL
NPI
1184066771
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225XG0600X Occupational Therapist, Gerontology
(Licence: FL OT10738)
Enumeration Date
2013-07-23
Last Update Date
2013-07-23
Business Address
Ms. JOHNNETHEL M FORT OTR/L
8495 NORMANDY BLVD
JACKSONVILLE, FL 32221-6701
Phone number: 904-783-3749
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Mailing Address
Ms. JOHNNETHEL M FORT OTR/L
1065 PEBBLE RIDGE DR
JACKSONVILLE, FL 32220-1323
Phone number: 904-343-1441
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