Individual
BRIAN MCDERMOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2173 SE HERRON AVE, PORT ST LUCIE, FL 34952-5854
(772) 485-4520
Mailing address
2173 SE HERRON AVE, PORT ST LUCIE, FL 34952-5854
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA19882
FL
Other
Enumeration date
08/18/2011
Last updated
08/18/2011
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