Individual
IRA J HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
9501 US HIGHWAY 441, LEESBURG, FL 34788-3950
(352) 435-6320
Mailing address
8915 SILVER LAKE DR, APT. 5, LEESBURG, FL 34788-3423
(352) 497-7486
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL1728
FL
Other
Enumeration date
05/17/2007
Last updated
07/29/2014
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