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Individual

JOSE ALVARO PONCE II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1620 HELVENSTON ST SE, LIVE OAK, FL 32064-3474
(626) 634-1128
Mailing address
103 HORIZON CIR SW, LIVE OAK, FL 32064-4934
(626) 634-1128

Taxonomy

Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
PT32963
FL

Other

Enumeration date
09/27/2020
Last updated
09/27/2020
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