Healthcare Provider Details

I. General information

NPI: 1487487542
Provider Name (Legal Business Name): WEST PALM BEACH PHYSIOTHERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2024
Last Update Date: 08/23/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CLAREMORE DR
WEST PALM BEACH FL
33401-7634
US

IV. Provider business mailing address

6856 GRAND MARSH CT
LAKE WORTH FL
33467
US

V. Phone/Fax

Practice location:
  • Phone: 732-589-4072
  • Fax:
Mailing address:
  • Phone: 732-589-4072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JESSE A CHALNICK
Title or Position: DOCTOR OF PHYSICAL THERAPY
Credential: DPT
Phone: 732-589-4072