Individual
BRYCE THORNTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 KAY LARKIN DR, PALATKA, FL 32177-2300
(386) 325-0173
Mailing address
809 WESTLAKE DR, ORMOND BEACH, FL 32174-1476
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
16953
FL
Other
Enumeration date
12/05/2018
Last updated
12/05/2018
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