Organization
3D SPORTS MEDICINE AND ORTHOPAEDIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDON HUDNALL LAT, ATC (ATHLETIC TRAINER/PHYSICIAN EXTENDER)
(540) 250-3085
Entity
Organization
Contact information
Practice address
2194 HIGHWAY A1A STE 104, INDIAN HARBOUR BEACH, FL 32937-4955
(321) 610-8939
Mailing address
2231 HAMPTON GREEN BLVD APT 105, MELBOURNE, FL 32935
(540) 250-3085
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
AL4490
FL
Other
Enumeration date
02/20/2017
Last updated
02/20/2017
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