Individual
MR. ALEX WILBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
1680 SW SAINT LUCIE WEST BLVD, SUITE 202, PORT ST LUCIE, FL 34986-1927
(772) 878-3322
(772) 878-5030
Mailing address
1680 SW SAINT LUCIE WEST BLVD, SUITE 202, PORT ST LUCIE, FL 34986-1927
(772) 878-3322
(772) 878-5030
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
25880
FL
Other
Enumeration date
09/18/2015
Last updated
09/18/2015
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