Provider Demographics
NPI:1972790517
Name:DURAN, JORGA SNYDER (PTA)
Entity type:Individual
Prefix:MS
First Name:JORGA
Middle Name:SNYDER
Last Name:DURAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 SE TRIBBLE ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-0108
Mailing Address - Country:US
Mailing Address - Phone:386-755-7263
Mailing Address - Fax:
Practice Address - Street 1:214 SE TRIBBLE ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-0108
Practice Address - Country:US
Practice Address - Phone:386-755-7263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA21026174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist