Individual
DETRA MORRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5440 OLD HIGHWAY 37, LAKELAND, FL 33811-2331
(863) 877-6287
Mailing address
PO BOX 6462, LAKELAND, FL 33807-6462
(863) 877-6287
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
FL
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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