Individual
MISS MARISSA LYNN SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1337 S INTERNATIONAL PKWY, LAKE MARY, FL 32746-1402
(407) 833-0802
Mailing address
1830 TURTLE HILL RD, ENTERPRISE, FL 32725-2452
(407) 314-3106
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
22209
FL
Other
Enumeration date
08/10/2011
Last updated
08/10/2011
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