Individual
LUKE JARED RETHERFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1690 US HIGHWAY 1 S, SAINT AUGUSTINE, FL 32084-4192
(904) 810-2101
Mailing address
3015 AQUA VISTA LN APT 111, SAINT AUGUSTINE, FL 32084-1262
(256) 436-3746
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
13677
FL
Other
Enumeration date
08/16/2009
Last updated
08/16/2009
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