Individual
LISA DESHA TRAINOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3720 SE JENNINGS RD, PORT ST LUCIE, FL 34952-7701
(772) 398-8080
Mailing address
6213 NW KUKUI CT, PORT ST LUCIE, FL 34983-3346
(772) 418-2751
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA21741
FL
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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