Individual
KYLE LEGROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
30 SKYLINE DR, LAKE MARY, FL 32746-6201
(407) 792-0031
Mailing address
4501 VINELAND RD STE 103, ORLANDO, FL 32811-7375
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA26359
FL
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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