Individual
JOACHIM BANNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4010 SOUTHPOINT DRIVE EAST, JACKSONVILLE, FL 32216
(904) 613-7688
Mailing address
4101 SOUTHPOINT DR E, JACKSONVILLE, FL 32216-0996
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA24173
FL
Other
Enumeration date
05/14/2014
Last updated
05/14/2014
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