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Patrick Brock Friar

Physical Therapy Assistant in Lake City, FL. Individual provider (NPI-1).

NPI number1669900247
StatusActive
Last updated in NPPESMay 26, 2017

Details

NPI
1669900247
Entity type
Individual (NPI-1)
Name
Patrick Brock Friar
Sex
Male
Sole proprietor
No
Enumeration date
May 26, 2017
Last updated
May 26, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225200000X Physical Therapy AssistantPTA25610FLYes

Practice location

587 Se Ermine Ave
Lake City, FL 32025-6126

Phone 386-438-2776

Mailing address

587 Se Ermine Ave
Lake City, FL 32025-6126

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