Individual
MISS ALICEN LEE WENDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, BSPTA
Contact information
Practice address
400 CELEBRATION PL, KISSIMMEE, FL 34747-4970
(407) 303-4000
Mailing address
1014 E JACKSON ST, ORLANDO, FL 32801-3040
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
30179
FL
Other
Enumeration date
12/20/2021
Last updated
12/23/2021
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