Individual
NOMARA JEANNE BUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
490 CENTRE LAKE DR NE, SUITE 100, PALM BAY, FL 32907-1189
(321) 768-9776
(321) 768-9739
Mailing address
1000 ABADA CT NE, APT 111, PALM BAY, FL 32905-3782
(321) 501-7332
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 14043
FL
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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