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Individual

JONATHAN BLAKE LUNSFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2708 NE 14TH ST, SUITE 5, POMPANO BEACH, FL 33062-3565
(888) 880-9270
Mailing address
9530 ROCKY RIVER RD, HARRISBURG, NC 28075-8609

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
25562702
NC

Other

Enumeration date
07/11/2011
Last updated
07/11/2011
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