Individual
OMAR CHAGOYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
713 30TH AVE E, BRADENTON, FL 34208-3913
(941) 405-2162
Mailing address
713 30TH AVE E, BRADENTON, FL 34208-3913
(941) 405-2162
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA29353
FL
Other
Enumeration date
02/20/2021
Last updated
02/20/2021
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