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1245893106
TEARA FREDERICK
KISSIMMEE, FL
NPI
1245893106
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: FL PTA29215)
Enumeration Date
2019-04-17
Last Update Date
2022-01-01
Business Address
TEARA FREDERICK
201 PARK PLACE BLVD
KISSIMMEE, FL 34741-2345
Phone number: 407-530-5063
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Mailing Address
TEARA FREDERICK
1200 FLORAL SPRINGS BLVD UNIT 27302
PORT ORANGE, FL 32129-6844
Phone number: 386-569-1618
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