Individual
NYDIA I VISSEPO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6663 SPRING GARDEN RUN, LAKE WORTH, FL 33463-7431
(561) 351-9277
Mailing address
6663 SPRING GARDEN RUN, LAKE WORTH, FL 33463-7431
(561) 351-9277
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1901
FL
Other
Enumeration date
02/13/2013
Last updated
02/13/2013
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