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Individual

ALIKS JESUS LORIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC, LAT

Contact information

Practice address
25 W CRYSTAL LAKE ST, ORLANDO, FL 32806-4475
(407) 254-2500
Mailing address
6910 RIVER RUN DR APT 101, TAMPA, FL 33617-9052
(305) 815-9223

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3523
FL

Other

Enumeration date
03/03/2023
Last updated
03/03/2023
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