Individual
JUAN PABLO VIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3505 LAKE LYNDA DR STE 207, ORLANDO, FL 32817-8327
(877) 896-3660
Mailing address
9308 ARLINGTON BLVD, FAIRFAX, VA 22031-2503
(703) 489-4533
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA20790
FL
Other
Enumeration date
05/25/2007
Last updated
07/08/2007
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