Individual
MR. JERMAIN MCNEEL TEZENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR, PT
Contact information
Practice address
1422 SAN MARCO BLVD, JACKSONVILLE, FL 32207-8536
(904) 398-4133
Mailing address
3717 SHADY MAPLE DR, LITHONIA, GA 30038-3346
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT 23875
FL
225X00000X
Occupational Therapist
Primary
OT 12890
FL
Other
Enumeration date
09/21/2007
Last updated
07/10/2008
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