Individual
MRS. JENNIFER LEE WALEKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
832 SUNSET LAKE BLVD, VENICE, FL 34292-7550
(941) 493-5536
Mailing address
872 SARANAC LAKE DR, UNIT #104, VENICE, FL 34292-7569
(412) 417-9360
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA20336
FL
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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