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General NPI Number Information
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NPI Number | 1306624069
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Entity Type | Organization
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Legal Business Name | HYDE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 09/14/2023
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 2250 HARRISON AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4548
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Country | US
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Telephone | 850-872-3715
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Fax | 850-769-1166
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Provider Business Mailing Address
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Address Line | 323 E 2ND ST
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City | PANAMA CITY
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State | FL
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Zip | 32401-3230
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Country | US
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Telephone | 850-238-0552
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Fax | 850-769-1166
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | JEFFREY D HYDE
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Credential | PT
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Telephone | 850-238-0650
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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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