Individual
MADISON LASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
11286 BOYETTE RD STE 101, RIVERVIEW, FL 33569-8022
(813) 978-9700
(813) 558-6185
Mailing address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0915
(813) 978-9700
(813) 558-6185
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA32622
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA32622
LICENSE
FL
Enumeration date
04/13/2023
Last updated
04/13/2023
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