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General NPI Number Information
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NPI Number | 1205455888
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Entity Type | Organization
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Legal Business Name | PANACEAS THERAPY CARE, LLC
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 04/13/2020
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Provider Practice Location Address
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Address Line | 6 CAYMAN CT
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City | FORT MYERS
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State | FL
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Zip | 33912-2003
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Country | US
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Telephone | 941-276-5710
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Fax |
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Provider Business Mailing Address
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Address Line | 6 CAYMAN CT
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City | FORT MYERS
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State | FL
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Zip | 33912-2003
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Country | US
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Telephone | 941-276-5710
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. DONALD CHARLES SCHULTZ III
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Credential | DPT, CSCS
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Telephone | 941-276-5710
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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 |
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License Number State |
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