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Individual

ED TYBURSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
18480 COCHRAN BLVD, PORT CHARLOTTE, FL 33948-3379
(941) 743-4700
Mailing address
6279 COLISEUM BLVD, PORT CHARLOTTE, FL 33981-6182
(941) 380-5031

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA6726
FL

Other

Enumeration date
02/25/2013
Last updated
02/25/2013
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