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General NPI Number Information
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NPI Number | 1073984191
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Entity Type | Organization
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Legal Business Name | PHYSIOTHERAPY ASSOCIATES
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Dates
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Enumeration Date | 10/15/2015
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Last Update Date | 10/15/2015
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Provider Practice Location Address
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Address Line | 134 E BLOOMINGDALE AVE
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City | BRANDON
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State | FL
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Zip | 33511-8101
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Country | US
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Telephone | 813-681-1627
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Fax |
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Provider Business Mailing Address
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Address Line | 134 E BLOOMINGDALE AVE
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City | BRANDON
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State | FL
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Zip | 33511-8101
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Country | US
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Telephone | 813-681-1627
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Fax |
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Authorized Official
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Title or Position | MULTI-SITE MANAGER
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Name | BETHANY ANDERSEN
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Credential | PT
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Telephone | 813-681-1627
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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 | 30569
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License Number State | FL
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