Individual
JONATHAN EDWARD HISLOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA, ATC, ITAT
Contact information
Practice address
1200 N CENTRAL AVE STE 110, KISSIMMEE, FL 34741-4439
(407) 201-7429
Mailing address
1200 N CENTRAL AVE STE 110, KISSIMMEE, FL 34741-4439
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
FL
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
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