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Individual

DR. JAKE LEY GILLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
17900 NW 5TH ST STE 102, PEMBROKE PINES, FL 33029-2809
(954) 367-4000
Mailing address
7230 TAFT ST, HOLLYWOOD, FL 33024-5430
(954) 907-3182

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
39611
FL

Other

Enumeration date
11/21/2022
Last updated
01/12/2023
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