Individual
LISA KATHERINE CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1129 PROFESSIONAL PARK DR, BRANDON, FL 33511-4887
(813) 876-8771
Mailing address
3909 BUTTONWOOD CT, BRANDON, FL 33511-7962
(813) 951-2725
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
25399
FL
Other
Enumeration date
06/01/2018
Last updated
06/01/2018
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