Individual
KETKI LASANIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
583 GRANT LOGAN DR, SAINT JOHNS, FL 32259-7330
(727) 808-7444
Mailing address
583 GRANT LOGAN DR, SAINT JOHNS, FL 32259-7330
(727) 808-7444
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
23738
FL
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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