Individual
MR. BRIAN LEWIS MUNDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
26540 ACE AVE, STE B, LEESBURG, FL 34748-8279
(352) 314-9810
(352) 314-9878
Mailing address
101 S 11TH ST, SUITE 3, LEESBURG, FL 34748-5767
(352) 787-3609
(352) 314-8979
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2005
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y910D
BCBS
FL
Enumeration date
08/30/2006
Last updated
07/08/2007
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