MEDICARE: EMPOWERHER HEALTH 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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1922803881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWERHER HEALTH PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	6593 SLABINSKI LN
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32404-8968
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	286 FOREST PARK CIR
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4921
Country	:	US
Telephone Number	:	850-270-8384
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	DR. BRIANA ELIZABETH TUCKER
Credential	:	PT, DPT
Telephone Number	:	912-281-2111

Provider Enumeration Date	:	02/15/2025
Last Update Date	:	02/15/2025

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