Individual
MRS. JESSICA RICHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
330 AVENUE C SE, WINTER HAVEN, FL 33880-3243
(863) 268-2903
Mailing address
1309 KEYSTONE PT, AUBURNDALE, FL 33823-2360
(863) 398-9085
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA25955
FL
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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