Individual
BRIAN DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1503 E 5TH AVE, TAMPA, FL 33605-5002
(813) 731-2181
Mailing address
1503 E 5TH AVE, TAMPA, FL 33605-5002
(813) 731-2181
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA26280
FL
Other
Enumeration date
02/16/2023
Last updated
02/16/2023
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