Individual
KAYLEE BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 W NORTH BLVD STE D, LEESBURG, FL 34748-5000
(352) 728-6636
Mailing address
600 W NORTH BLVD STE D, LEESBURG, FL 34748-5000
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA28061
FL
Other
Enumeration date
11/02/2017
Last updated
11/02/2017
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