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General NPI Number Information
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NPI Number | 1043279458
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Entity Type | Organization
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Legal Business Name | SOUTHWEST PHYSICAL THERAPY & REHABILITATION INC
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 10/15/2009
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Provider Practice Location Address
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Address Line | 4161 TAMIAMI TRL SUITE 304
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-9204
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Country | US
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Telephone | 941-613-2844
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Fax | 941-613-2840
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Provider Business Mailing Address
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Address Line | 4161 TAMIAMI TRL STE 304
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-9254
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Country | US
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Telephone | 941-613-2844
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Fax | 941-613-2840
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. JULITA E. LATHERS
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Credential | R.N.
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Telephone | 941-625-1530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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