Healthcare Provider Details

I. General information

NPI: 1457886145
Provider Name (Legal Business Name): PT SOLUTIONS OF PENSACOLA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 05/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 BARTRAM OAKS WALK SUITE 101
SAINT JOHNS FL
32259-3243
US

IV. Provider business mailing address

PO BOX 441146
KENNESAW GA
30160-9522
US

V. Phone/Fax

Practice location:
  • Phone: 678-459-3758
  • Fax:
Mailing address:
  • Phone: 678-403-3632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER HALL
Title or Position: CFO
Credential:
Phone: 770-615-4856