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1669984167
BRIAN TATUM
PORT ST LUCIE, FL
NPI
1669984167
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QD1600X Clinic/Center, Developmental Disabilities
Enumeration Date
2017-10-25
Last Update Date
2017-10-25
Business Address
BRIAN TATUM
6905 HERITAGE DR
PORT ST LUCIE, FL 34952-8227
Phone number: 772-370-5547
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Mailing Address
BRIAN TATUM
4230 SW CALLICOE ST
PORT SAINT LUCIE, FL 34953-3189
Phone number: 772-370-5547
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