Individual
JEFFREY MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
512 S 11TH ST, LAKE WALES, FL 33853-4901
(863) 676-8502
Mailing address
512 S 11TH ST, LAKE WALES, FL 33853-4901
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA28948
FL
Other
Enumeration date
02/14/2019
Last updated
02/14/2019
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