Individual
MISS LIANA BROOKE GODBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
560 SW MCFARLANE AVE, LAKE CITY, FL 32025-5614
(386) 758-4777
Mailing address
116 NW VETERANS ST APT 304, LAKE CITY, FL 32055-2809
(386) 365-8826
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA30806
FL
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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