Back On Track Physical Therapy, Llc | |
9080 Woodstork Ct Venice FL 34293-7614 | |
(941) 412-4465 | |
Not Available |
Full Name | Back On Track Physical Therapy, Llc |
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Speciality | Clinic/Center |
Location | 9080 Woodstork Ct, Venice, Florida |
Authorized Official Name and Position | Julie Kirby (MPT) |
Authorized Official Contact | 9417265392 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Back On Track Physical Therapy, Llc 9080 Woodstork Ct Venice FL 34293-7614 Ph: (941) 412-4465 | Back On Track Physical Therapy, Llc 9080 Woodstork Ct Venice FL 34293-7614 Ph: (941) 412-4465 |
NPI Number | 1700192689 |
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Provider Enumeration Date | 08/30/2010 |
Last Update Date | 03/21/2013 |
Medicare PECOS PAC ID | 9638368574 |
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Medicare Enrollment ID | O20150306001155 |
Identifier | Type | State | Issuer |
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1700192689 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | PT22716 (Florida) | Primary |
Provider Name | Julie Kirby |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1134386261 PECOS PAC ID: 3173677978 Enrollment ID: I20090813000121 |
Provider Name | Heather K Paben |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1427080696 PECOS PAC ID: 1254463177 Enrollment ID: I20100713000137 |
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