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1710116017
BRIAN SCOTT MICHNO
HEATHROW, FL
NPI
1710116017
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: NC 12211)
Enumeration Date
2009-07-08
Last Update Date
2009-07-08
Business Address
BRIAN SCOTT MICHNO
1485 INTERNATIONAL PKWY 2051
HEATHROW, FL 32746-5303
Phone number: 800-798-6035
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Mailing Address
BRIAN SCOTT MICHNO
105 1ST ST # B
ST AUGUSTINE, FL 32080-6364
Phone number:
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