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Individual

KHYRA JENAI FUNCHESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10726 KETCHUM VALLEY DR, RIVERVIEW, FL 33579-7185
(813) 819-1955
Mailing address
2210 MONACO VISTA DR APT 104, TAMPA, FL 33619-5029
(813) 363-1886

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA33620
FL

Other

Enumeration date
08/30/2024
Last updated
08/30/2024
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