Individual
LACI HENDERSHOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8477 S SUNCOAST BLVD, HOMOSASSA, FL 34446-5028
(352) 382-4800
Mailing address
8477 S SUNCOAST BLVD, HOMOSASSA, FL 34446-5028
(352) 382-4800
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA24949
FL
Other
Enumeration date
01/13/2017
Last updated
01/13/2017
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