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General NPI Number Information
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NPI Number | 1659985745
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Entity Type | Individual
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Provider Name | BRYLLE JOSEPH SEBIAL LABRA PT
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Gender | Male
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Dates
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Enumeration Date | 09/04/2020
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Last Update Date | 10/21/2020
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Provider Practice Location Address
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Address Line | 1880 37TH ST STE 1
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City | VERO BEACH
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State | FL
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Zip | 32960-6594
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Country | US
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Telephone | 772-213-9596
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Fax |
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Provider Business Mailing Address
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Address Line | 492 6TH ST
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City | VERO BEACH
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State | FL
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Zip | 32962-1861
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Country | US
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Telephone | 669-213-8967
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT36261
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License Number State | FL
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