Individual
LISA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
602 VONDERBURG DR, BRANDON, FL 33511-5900
(813) 653-1149
Mailing address
602 VONDERBURG DR, BRANDON, FL 33511-5900
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA4997
FL
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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