Healthcare Provider Details
I. General information
NPI: 1801064761
Provider Name (Legal Business Name): BETTER BODY PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/13/2008
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9401 SW STATE ROAD 200 BLDG. 2000, SUITE 2001
OCALA FL
34481
US
IV. Provider business mailing address
821 NE 36TH TER SUITE #8
OCALA FL
34470-2049
US
V. Phone/Fax
- Phone: 352-854-4017
- Fax: 352-854-4389
- Phone: 352-694-6466
- Fax: 352-694-3657
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT3979 |
| License Number State | FL |
VIII. Authorized Official
Name: MS.
LISA
DANIELS
GEORGE
Title or Position: OWNER
Credential: M.P.T.
Phone: 352-694-6466