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General NPI Number Information
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NPI Number | 1295884096
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Entity Type | Organization
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Legal Business Name | FLETCHER PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 03/28/2009
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Provider Practice Location Address
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Address Line | 824 S 14TH AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33020-6156
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Country | US
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Telephone | 954-628-2215
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Fax | 954-927-7931
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Provider Business Mailing Address
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Address Line | 824 S 14TH AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33020-6156
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Country | US
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Telephone | 954-628-2215
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Fax | 954-927-7931
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS PATRICK FLETCHER
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Credential | PT
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Telephone | 954-628-2215
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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 | PT5458
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License Number State | FL
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