Individual
BETHANY CLUBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
104 ASHOURIAN AVE STE 105, SAINT AUGUSTINE, FL 32092-5106
(904) 230-7761
Mailing address
3901 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4312
(904) 345-7251
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT41084
FL
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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