Individual
JOLENE LORIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
111 GRAND PALMS DR, PEMBROKE PINES, FL 33027-1329
(954) 822-3062
Mailing address
17832 SW 5TH ST, PEMBROKE PINES, FL 33029-4117
(954) 558-2198
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA18942
FL
Other
Enumeration date
01/02/2007
Last updated
07/08/2007
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