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1578043345
PHUONG LE
JACKSONVILLE, FL
NPI
1578043345
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: FL OTA14648)
Enumeration Date
2018-08-20
Last Update Date
2018-08-20
Business Address
PHUONG LE COTA/L
2802 PARENTAL HOME RD
JACKSONVILLE, FL 32216-5702
Phone number: 904-476-2994
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Mailing Address
PHUONG LE COTA/L
12001 ABESS BLVD APT 4211
JACKSONVILLE, FL 32225-6017
Phone number: 904-476-2994
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