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Individual

MS. HEATHER HERRON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
19123 180TH ST, LIVE OAK, FL 32060-6439
(386) 590-7283
Mailing address
19123 180TH ST, LIVE OAK, FL 32060-6439
(386) 590-7283

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA21888
FL

Other

Enumeration date
08/14/2012
Last updated
08/14/2012
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