Individual
NATHAN JIMMERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
319 W TOWN PL, WORLD GOLF VILLAGE, SUITE 5, SAINT AUGUSTINE, FL 32092-3101
(904) 342-5262
Mailing address
1138 LINWOOD LOOP, SAINT JOHNS, FL 32259-4235
(813) 784-4830
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 27099
FL
Other
Enumeration date
01/16/2017
Last updated
01/16/2017
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