Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1482 | FL |
NPI | 1144476383 |
---|---|
Provider Name | Mrs. Holly Michelle Bruinsma |
First Address | Orlando, FL 32828 |
Second Address | Orlando, FL 32804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2008 |
Last Update Date | 07/08/2008 |