MEDICARE: HEALTHWORKS PHYSICAL THERAPY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT2969	FL

General Provider Information

NPI Number	:	1699045062
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHWORKS PHYSICAL THERAPY, INC.

Provider Business Mailing Address
First Line	:	4240 5TH ST
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32968-1963
Country	:	US
Telephone Number	:	772-299-3383
Fax Number	:

Provider Business Practice Location Address
First Line	:	1060 6TH AVE
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-5922
Country	:	US
Telephone Number	:	772-299-3383
Fax Number	:	772-299-3367

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RONALD KEITH WILSON
Credential	:	PT
Telephone Number	:	772-299-3383

Provider Enumeration Date	:	01/03/2012
Last Update Date	:	01/03/2012

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