Individual
LARA MICHAELA VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
21760 FL-54 #102, LUTZ, FL 33549
(813) 252-0561
Mailing address
8435 PANAHAN DR, WEEKI WACHEE, FL 34613-4532
(727) 267-0613
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA30231
FL
Other
Enumeration date
08/11/2025
Last updated
08/11/2025
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