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Individual

MR. EDMUNDO LABIAL VILLANUEVA JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPT

Contact information

Practice address
5151 S LAKELAND DR, LAKELAND, FL 33813-2518
(863) 682-6182
Mailing address
5151 S LAKELAND DR, LAKELAND, FL 33813-2518
(863) 682-6182

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT16439
FL

Other

Enumeration date
06/14/2012
Last updated
06/14/2012
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