Individual
BRENNAN LEYENDECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1 ORTHOPAEDIC PL, ST AUGUSTINE, FL 32086-4202
(904) 825-0540
(904) 825-2490
Mailing address
4257 SUNNY BROOK WAY, APT 207, WINTER SPRINGS, FL 32708-6615
(352) 226-3080
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT25707
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT25707
FLORIDA LICENSE
FL
Enumeration date
07/27/2010
Last updated
07/27/2010
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