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General NPI Number Information
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NPI Number | 1437339819
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Entity Type | Organization
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Legal Business Name | VIP PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 11/14/2007
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 1484 E TERRA MAR DR
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City | POMPANO BEACH
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State | FL
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Zip | 33062-6839
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Country | US
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Telephone | 954-529-6236
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Fax | 954-946-9630
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Provider Business Mailing Address
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Address Line | 1484 E TERRA MAR DR
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City | POMPANO BEACH
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State | FL
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Zip | 33062-6839
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Country | US
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Telephone | 954-529-6236
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Fax | 954-946-9630
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK LEAGER
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Credential |
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Telephone | 954-529-6236
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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 | FL
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