BRIAN D RIDGELY

PORT ST LUCIE, FL
NPI1326062977
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: FL  PA3524)
Enumeration Date2006-07-27
Last Update Date2010-06-15
Business Address
-- BRIAN D RIDGELY PA
1651 SE TIFFANY AVE
PORT ST LUCIE, FL 34952-7564
Phone number: 772-398-1800
Mailing Address
-- BRIAN D RIDGELY PA
PO BOX 417
STUART, FL 34995-0417
Phone number: 772-223-5665