Individual
LISA XAYASONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1806 MAPLELEAF BLVD, OLDSMAR, FL 34677-2732
(737) 244-5391
Mailing address
10133 SHERRILL BLVD STE 200, KNOXVILLE, TN 37932-3347
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
11802
FL
Other
Enumeration date
06/18/2021
Last updated
06/18/2021
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