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NPI Code Detail

MEDICARE: RESOLUTE PHYSICAL THERAPY LLC

MEDICARE: RESOLUTE PHYSICAL THERAPY LLC
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
1261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1831804228
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESOLUTE PHYSICAL THERAPY LLC
Provider Business Mailing Address
First Line : 2284 LAS VEGAS TRL
Second Line :
City : NAVARRE
State : FL
Zip : 32566-7573
Country : US
Telephone Number : 706-726-0113
Fax Number :
Provider Business Practice Location Address
First Line : 2284 LAS VEGAS TRL
Second Line :
City : NAVARRE
State : FL
Zip : 32566-7573
Country : US
Telephone Number : 706-726-0113
Fax Number :
Authorized Official
Title or Position : OWNER
Name : AMBER CALHOUN
Credential : DPT
Telephone Number : 706-726-0113
Provider Enumeration Date : 01/19/2023
Last Update Date : 01/19/2023

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Directions to “RESOLUTE PHYSICAL THERAPY LLC ” Practice Location

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