Individual
JERICKA SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10105 W OHIO DR, CRYSTAL RIVER, FL 34428
(352) 613-4149
Mailing address
10105 W OHIO DR, CRYSTAL RIVER, FL 34428-9680
(352) 613-4149
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 23916
FL
Other
Enumeration date
02/25/2013
Last updated
02/25/2013
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