Individual
MR. BRYAN WAYNE LOVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9050 58TH DR E, SUITE #101, LAKEWOOD RANCH, FL 34202-6104
(941) 807-5240
Mailing address
5429 CARSO TER, NORTH PORT, FL 34286-6428
(941) 429-6453
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA30231
FL
Other
Enumeration date
10/04/2013
Last updated
10/04/2013
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