Individual
MR. BRIAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
15204 W COLONIAL DR, WINTER GARDEN, FL 34787-6042
(407) 877-2394
Mailing address
5247 COUNTY ROAD 561, CLERMONT, FL 34714-8808
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
PTA23307
FL
Other
Enumeration date
05/01/2014
Last updated
05/01/2014
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