Individual
GIACO ANDRAE NANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
3110 OAKBRIDGE BLVD E, LAKELAND, FL 33803-5987
(863) 648-4800
Mailing address
1830 GRAND BAY CIR APT 203, LAKELAND, FL 33810-1852
(863) 602-3936
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA24030
FL
Other
Enumeration date
05/20/2013
Last updated
05/20/2013
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