Individual
EDWARD JAMES MCGLENNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
758 CORTARO DR, RUSKIN, FL 33573-6803
(813) 938-5878
Mailing address
758 CORTARO DR, RUSKIN, FL 33573-6803
(813) 938-5878
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 11701
FL
Other
Enumeration date
07/20/2011
Last updated
07/20/2011
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