Individual
BRIAN MICHAEL WAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
8399 BAYBERRY RD, JACKSONVILLE, FL 32256
(904) 260-4977
Mailing address
8774 SPRING HARVEST LN E, JACKSONVILLE, FL 32244-7452
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT22014
FL
Other
Enumeration date
09/08/2005
Last updated
07/08/2007
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