Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1740520501 |
---|---|
Provider Name | Mr. Ronald J Pryor JR. |
First Address | Sanford, FL 32771-7979 |
Second Address | Longwood, FL 32750-6015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2013 |
Last Update Date | 15/02/2013 |