Individual
MR. LESLIE A SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
14910 MAIN ST, ALACHUA, FL 32615-8591
(352) 462-1843
Mailing address
14910 MAIN ST, ALACHUA, FL 32615-8591
(352) 462-1843
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
21098
FL
Other
Enumeration date
12/09/2007
Last updated
12/09/2007
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