Individual
ALYSHA MARIE POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1274 BEE ST N, ORANGE PARK, FL 32065-7375
(904) 207-8773
Mailing address
1274 BEE ST N, ORANGE PARK, FL 32065-7375
(904) 207-8773
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA28863
FL
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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