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Individual

NIEMAT ISSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1771 EDGEWOOD AVE W STE 6B, JACKSONVILLE, FL 32208-7208
(904) 768-9966
(904) 367-8760
Mailing address
1771 EDGEWOOD AVE W STE 6B, JACKSONVILLE, FL 32208-7208
(904) 768-9966
(904) 367-8760

Taxonomy

Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
OT6568
FL

Other

Enumeration date
04/06/2015
Last updated
07/21/2022
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