Individual
MRS. JEREMY DALISAY CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6798 ASHBURN RD, LAKE WORTH, FL 33467-7319
(561) 603-5389
Mailing address
6798 ASHBURN RD, LAKE WORTH, FL 33467-7319
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
225200000X
Physical Therapy Assistant
Primary
PTA21191
FL
Other
Enumeration date
04/04/2008
Last updated
08/31/2012
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