Individual
JASON MIMMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
305 E OAK ST, APOPKA, FL 32703-4352
(407) 335-0360
Mailing address
581 N PARK AVE UNIT 145, APOPKA, FL 32704-8607
(407) 335-0360
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA25078
FL
Other
Enumeration date
08/31/2017
Last updated
08/31/2017
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