Individual
JORDAN DAVID PRIEBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5245 N SOCRUM LOOP RD, LAKELAND, FL 33809-4253
(863) 859-1446
Mailing address
16744 CAGAN CROSSINGS BLVD, APT. 7, CLERMONT, FL 34714-4886
(321) 439-1356
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
25673
FL
Other
Enumeration date
05/25/2015
Last updated
05/25/2015
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