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Individual

LAVANYA DEVATHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1 OAKWOOD BLVD, #130, HOLLYWOOD, FL 33020-1956
(954) 925-3844
Mailing address
5396 BROAD ST, APT H, MILTON, FL 32570-2239
(443) 641-7862

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT32017
FL

Other

Enumeration date
02/04/2017
Last updated
02/04/2017
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