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Individual

JAN MASON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6416 GOLDEN EYE GLN, LAKEWOOD RANCH, FL 34202-5834
(941) 993-6443
Mailing address
6416 GOLDEN EYE GLN, LAKEWOOD RANCH, FL 34202-5834
(941) 993-6443

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M250433772040
LIC NUMBER
FL
Enumeration date
11/04/2013
Last updated
11/04/2013
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