Individual
MATTIE BELL THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NON MEDICAL
Contact information
Practice address
2220 BELVEDERE ST, JACKSONVILLE, FL 32208-2152
(904) 764-0593
(904) 764-0647
Mailing address
2220 BELVEDERE ST, JACKSONVILLE, FL 32208-2152
(904) 764-0593
(904) 764-0647
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
320700000X
FL
Other
Enumeration date
03/15/2010
Last updated
03/15/2010
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