| |
176 Sw Midtown Pl, Suite 103, Lake City, FL 32025-0757 | |
(386) 754-9221 | |
(386) 754-9530 |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 176 Sw Midtown Pl, Lake City, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1932217601 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
1300 W Sam Houston Pkwy S, Suite 300, Houston, TX 77042-2447 Ph: (713) 297-7000 | 176 Sw Midtown Pl, Suite 103, Lake City, FL 32025-0757 Ph: (386) 754-9221 |