JOHN KWAK-HEFFERAN

PORT ORANGE, FL
NPI1316391014
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: IL  160007217)
Enumeration Date2016-04-19
Last Update Date2016-04-19
Business Address
-- JOHN KWAK-HEFFERAN
5535 S WILLIAMSON BLVD SUITE 774
PORT ORANGE, FL 32128-8311
Phone number: 800-330-7711
Mailing Address
-- JOHN KWAK-HEFFERAN
5535 S WILLIAMSON BLVD SUITE 774
PORT ORANGE, FL 32128-8311
Phone number: 800-330-7711
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