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Individual

DARYL LAWRENCE VERGARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.A.

Contact information

Practice address
84 PINNACLES DR, #300, PALM COAST, FL 32164-2324
(386) 447-7824
Mailing address
19 RAE DR, PALM COAST, FL 32164-6880
(386) 237-8588

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
22353
FL

Other

Enumeration date
05/05/2016
Last updated
05/05/2016
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