Individual
JAYNA DINSMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T., P.T.A
Contact information
Practice address
321 IMPERIAL BLVD, D38, LAKELAND, FL 33803
(186) 093-0294
Mailing address
321 IMPERIAL BLVD, D38, LAKELAND, FL 33803-5622
(860) 930-2948
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
1564
CT
225200000X
Physical Therapy Assistant
Primary
PTA 26011
FL
225700000X
Massage Therapist
1315
CT
225700000X
Massage Therapist
MA79747
FL
Other
Enumeration date
11/05/2015
Last updated
02/04/2016
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