Healthcare Provider Details

I. General information

NPI: 1083672984
Provider Name (Legal Business Name): ON THE GO THERAPY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 05/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5968 CLARK CENTER AVE
SARASOTA FL
34238-2715
US

IV. Provider business mailing address

5968 CLARK CENTER AVE
SARASOTA FL
34238-2715
US

V. Phone/Fax

Practice location:
  • Phone: 941-922-8200
  • Fax: 941-343-9402
Mailing address:
  • Phone: 941-922-8200
  • Fax: 941-343-9402

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
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIE A BLANK
Title or Position: PRESIDENT
Credential: PT
Phone: 941-922-8200