Individual
MRS. MARY BERNADETTE KLOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
5201 RAYMOND ST, ORLANDO, FL 32803-8208
(407) 599-1500
Mailing address
952 BIRD BAY CT, LAKE MARY, FL 32746-2003
(407) 330-0901
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 19736
FL
Other
Enumeration date
06/14/2006
Last updated
07/08/2007
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