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General NPI Number Information
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NPI Number | 1356920862
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Entity Type | Organization
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Legal Business Name | ATHLETIC SOLUTIONS, PLLC
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Dates
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Enumeration Date | 04/03/2021
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 1844 TAMIAMI TRL
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City | PUNTA GORDA
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State | FL
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Zip | 33950-5916
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Country | US
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Telephone | 941-205-8956
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Fax |
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Provider Business Mailing Address
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Address Line | 23016 WALTON AVE
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-1709
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Country | US
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Telephone | 941-380-1872
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JASON BURNS
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Credential | DPT
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Telephone | 941-380-1872
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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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