MASON KEITH ROACH

TAVARES, FL
NPI1568691616
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: FL  PTA 20936)
Enumeration Date2009-07-10
Last Update Date2009-07-10
Business Address
-- MASON KEITH ROACH
2762 DORA AVE
TAVARES, FL 32778-4970
Phone number: 352-742-7837
Mailing Address
-- MASON KEITH ROACH
37015 RANCH RD
EUSTIS, FL 32736-8413
Phone number: 352-455-7493