Goodstein Brian S - Florida Health Professionals
County | MANATEE |
---|---|
Address (Line 1) | BOLLETTIERI SPORTS ACADEMY |
Address (Line 2) | 5500 34TH STREET W |
Address (City) | BRADENTON |
Address (State) | FL |
Address (Zip Code) | 34210 |
Profession | Athletic Trainer |
File Number | 1146 |
License Expiration Date | 5/31/2002 |
Original Date | 10/31/2000 |
Rank Code | AL |
License Number | 1161 |
Status Effective Date | 11/30/2004 |
Phone Number (Area Code) | 941 |
---|---|
Phone Number | 752-2561 |
Practice Location (Address Line1) | BOLLETTIERI SPORTS ACADEMY |
Practice Location (Address Line 2) | 5500 34TH STREET W |
Practice Location (City) | BRADENTON |
Practice Location (State) | FL |
Practice Location (Zip Code) | 34210 |
Prescribe Ind | N |
Full Name | GOODSTEIN BRIAN S |
Board Action Indicator | N |
License Status Description | NULL AND VOID |
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