Individual
BRANDON MICHAEL MCKOWN VIDAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
75 CYRILLA CT, PENSACOLA, FL 32506-6826
(850) 982-8535
Mailing address
75 CYRILLA CT, PENSACOLA, FL 32506-6826
(850) 982-8535
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/04/2018
Last updated
07/04/2018
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