Doctor Name: | MR. BRIAN LEWIS MUNDY |
NPI Number: | 1053420364 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | PT2005 |
Business Practice Address: | 26540 Ace Ave Ste B Leesburg, FL - 347488279 |
Business Phone Number: | 3523149810 |
Business Fax Number: | 3523149878 |
Mailing Address: | 101 S 11th St, Suite 3 LEESBURG |
State: | FL |
Postal Code: | 347485767 |
Phone Number: | 3527873609 |
Fax Number: | 3523148979 |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT2005 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |