Most Relevant Information
Provider Data
| NPI Number: | 1003024456 |
| Provider Name: | DONNA LOUISE WORLEY PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 313M00000X |
| Specialty: | Nursing Facility/Intermediate Care Facility |
| License Number: | PTA 19889 |
Most Important Dates
| Enumeration Date: | 05/18/2007 |
| Last Updated: | 07/09/2007 |
Provider Practice Location
4240 LAKELAND HIGHLANDS RD
LAKELAND
FL
338133113
Practice Location Phone/Fax
| Phone: | 8636075948 |
| Fax: | 8636444202 |
Provider Mailing Location
4355 OSTEEN LN
MULBERRY
FL
338609718
Provider Mailing Phone/Fax
| Phone: | 8634254883 |
| Fax: |