Individual
LESLIE THERESE SHUTACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
6658 NW 4TH AVE, OCALA, FL 34475
(352) 342-1679
Mailing address
6658 NW 4TH AVE, OCALA, FL 34475
(352) 342-1679
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA19384
FL
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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