Individual
MISS MARI JANE ACADEMIA TICZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
11 PONTIAC AVE, WEBSTER, MA 01570-1629
(508) 943-3889
Mailing address
3201 W COMMERCIAL BLVD, SUITE 116, FT LAUDERDALE, FL 33309-3440
(954) 739-4247
(954) 332-4340
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17763
MA
Other
Enumeration date
09/25/2007
Last updated
09/25/2007
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