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General NPI Number Information
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NPI Number | 1356353437
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY IN YOUR HOME INC
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7200 W CAMINO REAL SUITE 101
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City | BOCA RATON
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State | FL
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Zip | 33433-5511
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Country | US
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Telephone | 561-237-2488
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Fax |
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Provider Business Mailing Address
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Address Line | 2170 SW 7TH CT
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City | BOCA RATON
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State | FL
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Zip | 33486-6951
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. EDWARD JOHN MCCORMACK JR.
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Credential | PT
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Telephone | 561-789-2046
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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 | PT 4994
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License Number State | FL
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