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1639401433
JACQUELINE DANIELLE SHIFTLETT
ORLANDO, FL
NPI
1639401433
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: FL 20546)
Enumeration Date
2010-02-03
Last Update Date
2010-08-06
Business Address
-- JACQUELINE DANIELLE SHIFTLETT pta
11301 CORPORATE BLVD STE 101
ORLANDO, FL 32817-8355
Phone number: 800-774-7785
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Mailing Address
-- JACQUELINE DANIELLE SHIFTLETT pta
1409 PERIWINKLE CT.
LAKELAND, FL 33811
Phone number:
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