Individual
MS. JOHNNETHEL M FORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
8495 NORMANDY BLVD, JACKSONVILLE, FL 32221-6701
(904) 783-3749
Mailing address
1065 PEBBLE RIDGE DR, JACKSONVILLE, FL 32220-1323
(904) 343-1441
(904) 786-2813
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
OT10738
FL
Other
Enumeration date
07/23/2013
Last updated
07/23/2013
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