Individual
JILLIAN HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 PARK CENTER DR STE 202, ORLANDO, FL 32835-6235
(407) 286-2021
Mailing address
609 W 8TH ST, LAKELAND, FL 33805-4327
(315) 577-2187
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
RBT-20-145573
FL
Other
Enumeration date
03/31/2022
Last updated
03/31/2022
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