Individual
BRENT VANDERZYL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
190 E CEDARWOOD CIR, KISSIMMEE, FL 34743-9070
(407) 791-2366
Mailing address
190 E CEDARWOOD CIR, KISSIMMEE, FL 34743-9070
(407) 791-2366
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL2701
FL
Other
Enumeration date
08/12/2009
Last updated
08/12/2009
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