Individual
BRIAN SCOTT MICHNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1485 INTERNATIONAL PKWY, 2051, HEATHROW, FL 32746-5303
(800) 798-6035
Mailing address
105 1ST ST # B, ST AUGUSTINE, FL 32080-6364
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12211
NC
Other
Enumeration date
07/08/2009
Last updated
07/08/2009
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