Individual
AUDREY STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
4450 W EAU GALLIE BLVD, SUITE 180, MELBOURNE, FL 32934-7213
(321) 255-6627
Mailing address
4775-2 LAKE WATERFORD WAY, MELBOURNE, FL 32901
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT25525
FL
Other
Enumeration date
06/09/2010
Last updated
08/03/2010
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