Individual
BREANNA DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9889 GATE PKWY N, JACKSONVILLE, FL 32246-9228
(904) 513-3954
Mailing address
12337 WYNNFIELD LAKES DR UNIT 1021, JACKSONVILLE, FL 32246-4261
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA30781
FL
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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