Individual
MR. JAYLON VAUGHN MIKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
8726 DEEP MAPLE DR, RIVERVIEW, FL 33578-8979
(918) 237-9871
Mailing address
8726 DEEP MAPLE DR, RIVERVIEW, FL 33578-8979
(918) 237-9871
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA32592
FL
Other
Enumeration date
03/16/2023
Last updated
03/16/2023
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