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General NPI Number Information
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NPI Number | 1205115144
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Entity Type | Organization
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Legal Business Name | ALLIN PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 08/10/2011
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 10395 NARCOOSSEE RD SUITE E
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City | ORLANDO
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State | FL
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Zip | 32832-6939
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Country | US
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Telephone | 407-608-9189
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Fax | 407-482-4575
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Provider Business Mailing Address
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Address Line | 10395 NARCOOSSEE RD SUITE E
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City | ORLANDO
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State | FL
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Zip | 32832-6939
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Country | US
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Telephone | 407-608-9189
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Fax | 407-482-4575
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Authorized Official
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Title or Position | OWNER / OPERATOR
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Name | MR. RICHARD PANCHO GAJO
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Credential | PT
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Telephone | 407-608-9189
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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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