Individual
LORNA CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
123 S RIDGE AVE, MIDDLETOWN, DE 19709-4642
(516) 859-3829
Mailing address
123 S RIDGE AVE, MIDDLETOWN, DE 19709-4642
(516) 859-3829
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
J2-0001390
DE
Other
Enumeration date
02/19/2020
Last updated
02/19/2020
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