Individual
MR. CHRISTOPHER WAYNE GENTILCORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
346 E ROYAL PALM ST STE 1, LAKE PLACID, FL 33852-5055
(863) 465-9500
Mailing address
635 S 5TH AVE APT D207, WAUCHULA, FL 33873-3154
(541) 297-0554
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA30873
FL
Other
Enumeration date
03/08/2021
Last updated
03/08/2021
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