Individual
JAMI LALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1240 PINEBROOK RD, VENICE, FL 34285-6421
(941) 525-4326
Mailing address
1240 PINEBROOK RD, VENICE, FL 34285-6421
(941) 525-4326
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA19937
FL
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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