Individual
JOSE L AYALA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
560 SW MCFARLANE AVE, LAKE CITY, FL 32025-5614
(386) 758-4777
Mailing address
159 SW CLEWISTON CT # B, FORT WHITE, FL 32038-4557
(352) 398-2695
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
123128
FL
Other
Enumeration date
03/24/2020
Last updated
03/24/2020
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