| Fundamental Therapy Inc | |
|
4106 N 48th Ave, Hollywood, FL 33021-1735 | |
| (954) 648-7819 | |
| Not Available |
| Full Name | Fundamental Therapy Inc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist - Pediatrics |
| Location | 4106 N 48th Ave, Hollywood, Florida |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922607845 | NPI | - | NPPES |
| 000288300 | Medicaid | FL | |
| PT20744 | Other | FL | PHYSICAL THERAPY LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2251P0200X | Physical Therapist - Pediatrics | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Fundamental Therapy Inc 4106 N 48th Ave, Hollywood, FL 33021-1735 Ph: (954) 648-7819 | Fundamental Therapy Inc 4106 N 48th Ave, Hollywood, FL 33021-1735 Ph: (954) 648-7819 |
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