Individual
KENT LIPPERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
333 1ST ST N, SUITE 2001, JACKSONVILLE BEACH, FL 32250-6945
(800) 920-5038
Mailing address
PO BOX 1154, MELBOURNE, FL 32902-1154
(321) 848-2066
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14121
FL
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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