Individual
IAN GRANT LOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
16690 SW CHIPOLA RD, BLOUNTSTOWN, FL 32424-1953
(850) 674-6405
Mailing address
4191 N LANDAR DR, LAKE WORTH, FL 33463-8906
(561) 676-4907
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
PT30985
FL
Other
Enumeration date
12/09/2015
Last updated
12/09/2015
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