Individual
MRS. LINDA S JOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WSC
Contact information
Practice address
800 VIRGINIA AVE STE 59 F, FORT PIERCE, FL 34982-5892
(772) 468-9333
(772) 468-9360
Mailing address
3450 NW 172ND CT, OKEECHOBEE, FL 34972-8480
(863) 467-0014
(772) 468-9360
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68994868
—
FL
Enumeration date
09/22/2006
Last updated
07/09/2007
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