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Organization
LYMPHEDEMA TREATMENT CENTER LLC
Active
Organization
LYMPHEDEMA TREATMENT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE MARSHA CORRALES OTR/L (OWNER/ THERAPIST)
(904) 425-4391
Entity
Organization
Contact information
Practice address
11512 LAKE MEAD AVE UNIT 604, JACKSONVILLE, FL 32256-9686
(904) 425-4391
(904) 425-4392
Mailing address
11512 LAKE MEAD AVE UNIT 604, JACKSONVILLE, FL 32256-9686
(904) 425-4391
(904) 425-4392
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT12323
FL
Other
Enumeration date
02/22/2008
Last updated
02/22/2008
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