Individual
MRS. LISA CHESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2365 5TH AVE N, SAINT PETERSBURG, FL 33713-7005
(727) 328-7879
Mailing address
2365 5TH AVE N, SAINT PETERSBURG, FL 33713-7005
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
10755
FL
Other
Enumeration date
10/13/2008
Last updated
10/13/2008
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