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1396120911
LEON TREMAINE JACKSON
ORLANDO, FL
NPI
1396120911
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: FL OTA14670)
Enumeration Date
2015-07-24
Last Update Date
2015-07-24
Business Address
-- LEON TREMAINE JACKSON COTA/L
601 S SEMORAN BLVD
ORLANDO, FL 32807-3120
Phone number: 321-368-2172
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Mailing Address
-- LEON TREMAINE JACKSON COTA/L
12013 ISLAND BAY CIR
SANFORD, FL 32771-6352
Phone number: 407-459-6264
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