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Individual

MABELLE TERCERO MCPHILOMY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
177 BRENTLEY LN, ORANGE PARK, FL 32065-5615
(951) 796-7268
Mailing address
177 BRENTLEY LN, ORANGE PARK, FL 32065-5615
(951) 796-7268

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT30861
FL

Other

Enumeration date
12/28/2015
Last updated
12/29/2015
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