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Individual

MS. JENNIFER J THEOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1333 SANTA BARBARA BLVD, CAPE CORAL, FL 33991-2803
(239) 772-1333
Mailing address
13211 WHITEHAVEN LN, FORT MYERS, FL 33966-1518
(239) 247-3096

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
21101
FL

Other

Enumeration date
11/19/2011
Last updated
11/19/2011
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