Individual
KATELYN JAE BOONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4217 SW 61ST AVE, DAVIE, FL 33314-3614
(972) 977-8489
Mailing address
4217 SW 61ST AVE, DAVIE, FL 33314-3614
(972) 977-8489
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
28959
FL
Other
Enumeration date
11/06/2018
Last updated
11/06/2018
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