Individual
MRS. BETHANY JOY NKOSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, ATL
Contact information
Practice address
1600 LAKELAND HILLS BLVD, LAKELAND, FL 33805-3019
(863) 680-7088
Mailing address
12816A SYDNEY RD, DOVER, FL 33527-5961
(850) 449-2846
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL1459
FL
Other
Enumeration date
04/13/2006
Last updated
04/10/2009
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