Individual
GINNA LORRAINE BOUALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1565 SAXON BLVD STE 301, DELTONA, FL 32725-5836
(386) 851-0901
(386) 851-2426
Mailing address
107 BELCHASE CT, DEBARY, FL 32713-2209
(407) 489-0785
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 21423
FL
Other
Enumeration date
09/22/2008
Last updated
09/22/2008
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