Individual
MR. BRIAN J HATLELID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
4600 4TH ST N, ST PETERSBURG, FL 33703-3802
(727) 527-5272
(727) 522-7412
Mailing address
4600 4TH ST N, ST PETERSBURG, FL 33703-3802
(727) 527-5272
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6221
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT36657
STATE LICENSE
FL
Enumeration date
03/13/2007
Last updated
03/08/2021
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