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MR. JOHNNY WAYNE GUY II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTA

Contact information

Practice address
1310 37TH ST, VERO BEACH, FL 32960-4860
(772) 569-5107
Mailing address
1720 MURRELL RD APT 215, ROCKLEDGE, FL 32955-3255
(321) 280-0577

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
10899
FL

Other

Enumeration date
08/26/2017
Last updated
08/26/2017
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