LEON TREMAINE JACKSON

ORLANDO, FL
NPI1396120911
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: FL  OTA14670)
Enumeration Date2015-07-24
Last Update Date2015-07-24
Business Address
-- LEON TREMAINE JACKSON COTA/L
601 S SEMORAN BLVD
ORLANDO, FL 32807-3120
Phone number: 321-368-2172
Mailing Address
-- LEON TREMAINE JACKSON COTA/L
12013 ISLAND BAY CIR
SANFORD, FL 32771-6352
Phone number: 407-459-6264