Individual
AMY LYNN PROTHEROE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2725 ROBIE AVE, MOUNT DORA, FL 32757-9619
(800) 626-3876
Mailing address
10265 GANDY BLVD N APT 1003, ST PETERSBURG, FL 33702-2332
(407) 733-1165
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
20805
FL
Other
Enumeration date
06/10/2020
Last updated
07/24/2020
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