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General NPI Number Information
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NPI Number | 1043551260
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Entity Type | Organization
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Legal Business Name | THERAPEUTICFX, LLC
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Dates
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Enumeration Date | 03/13/2013
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Last Update Date | 03/13/2013
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Provider Practice Location Address
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Address Line | 1311 E OAK ST
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City | ARCADIA
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State | FL
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Zip | 34266-8902
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Country | US
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Telephone | 941-204-0745
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Fax |
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Provider Business Mailing Address
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Address Line | 1311 E OAK ST
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City | ARCADIA
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State | FL
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Zip | 34266-8902
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Country | US
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Telephone | 941-204-0745
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Fax |
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Authorized Official
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Title or Position | OTR/L
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Name | GERDA JEAN
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Credential | OT
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Telephone | 941-204-0745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | ARDMS 105953
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License Number State | FL
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