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1417641010
KYLIE JAE LAVINE
ST AUGUSTINE, FL
NPI
1417641010
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: FL PTT40277)
Enumeration Date
2023-06-06
Last Update Date
2023-06-06
Business Address
KYLIE JAE LAVINE
200 SOUTHPARK BLVD STE 102
ST AUGUSTINE, FL 32086-3129
Phone number: 774-670-8023
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Mailing Address
KYLIE JAE LAVINE
3400 GULF SHORE BLVD N APT N8
NAPLES, FL 34103-3609
Phone number: 774-670-8023
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