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General NPI Number Information
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NPI Number | 1033274287
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Entity Type | Organization
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Legal Business Name | BACK IN ACTION
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3720 COCONUT CREEK PKWY SUITE A
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City | COCONUT CREEK
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State | FL
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Zip | 33066-1634
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Country | US
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Telephone | 954-978-0209
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Fax | 954-978-1619
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Provider Business Mailing Address
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Address Line | 3720 COCONUT CREEK PKWY SUITE A
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City | COCONUT CREEK
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State | FL
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Zip | 33066-1634
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Country | US
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Telephone | 954-978-0209
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Fax | 954-978-1619
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. SALMON Y LEVIN
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Credential | R.P.T.
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Telephone | 954-978-0209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0009963
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License Number State | FL
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