Individual
MR. BRUCE MCKNIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
633 HAMLET DR, PORT ORANGE, FL 32127-5973
(386) 788-3061
Mailing address
633 HAMLET DR, PORT ORANGE, FL 32127-5973
(386) 788-3061
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2983
FL
Other
Enumeration date
05/18/2007
Last updated
12/10/2009
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