Individual
ALLAN GASNER DERIZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
863 MARIETTA LN, EUSTIS, FL 32726-5143
(352) 357-4147
Mailing address
863 MARIETTA LN, EUSTIS, FL 32726-5143
(352) 357-4147
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
31681
FL
Other
Enumeration date
12/30/2021
Last updated
12/30/2021
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