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General NPI Number Information
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NPI Number | 1467541417
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Entity Type | Organization
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Legal Business Name | PORT ORANGE PHYSICAL THERAPY LIMITED PARTNERSHIP
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 08/02/2007
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Provider Practice Location Address
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Address Line | 900 N SWALLOWTAIL DR SUITE 107
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City | PORT ORANGE
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State | FL
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Zip | 32129-6103
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Country | US
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Telephone | 386-322-4641
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Fax | 386-322-4677
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Provider Business Mailing Address
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Address Line | 1300 W SAM HOUSTON PKWY S SUITE 300
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City | HOUSTON
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State | TX
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Zip | 77042-2453
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Country | US
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Telephone | 713-297-7000
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Fax | 713-297-7090
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Authorized Official
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Title or Position | VP,AUTHORIZED OFFICIAL
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Name | JANNA P. KING
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Credential | JD
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Telephone | 713-297-7000
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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 |
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Taxonomy #2
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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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