Provider Demographics
NPI:1760835599
Name:READY, BRYCE (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:BRYCE
Middle Name:
Last Name:READY
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7345 W SAND LAKE RD STE 301
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5281
Mailing Address - Country:US
Mailing Address - Phone:407-704-7919
Mailing Address - Fax:
Practice Address - Street 1:7345 W SAND LAKE RD STE 301
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5281
Practice Address - Country:US
Practice Address - Phone:407-704-7919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-17
Last Update Date:2016-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL8022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer