Individual
JENNIFER EVANS LIGHTFOOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
411 NORTH MCDONALD AVE, DELAND, FL 32742
(386) 682-7300
Mailing address
411 NORTH MCDONALD AVE, DELAND, FL 32742
(386) 682-7300
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA9027
FL
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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