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1780341503
MARVELL DERON TOLBERT
LAKELAND, FL
NPI
1780341503
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: FL OTA18447)
Enumeration Date
2021-11-29
Last Update Date
2021-11-29
Business Address
MARVELL DERON TOLBERT OTA
16 LAKE HUNTER DR
LAKELAND, FL 33803-1297
Phone number: 863-577-6063
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Mailing Address
MARVELL DERON TOLBERT OTA
8477 S SUNCOAST BLVD
HOMOSASSA, FL 34446-5028
Phone number: 800-804-9961
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