Individual
JESSICA ANNE POLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT
Contact information
Practice address
206 RIDGEWOOD AVE, BRANDON, FL 33510-4617
(813) 662-1060
Mailing address
11923 SUMMER SPRINGS DR, RIVERVIEW, FL 33579-4079
(402) 850-8639
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT21591
FL
Other
Enumeration date
06/30/2021
Last updated
06/30/2021
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