Individual
BRENDA LEA DEMENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 SEAGRASS DR, PANAMA CITY BEACH, FL 32407-2597
(850) 249-2004
Mailing address
2075A FERGUSON RD, CHIPLEY, FL 32428-3842
(850) 866-2245
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2164
FL
Other
Enumeration date
05/04/2021
Last updated
05/04/2021
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