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General NPI Number Information
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NPI Number | 1497427413
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Entity Type | Organization
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Legal Business Name | VERSATILE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 09/28/2021
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 1010 KENNEDY DR STE 407
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City | KEY WEST
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State | FL
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Zip | 33040-4134
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Country | US
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Telephone | 305-709-1132
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Fax | 865-500-3729
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Provider Business Mailing Address
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Address Line | PO BOX 3088
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City | COLORADO SPRINGS
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State | CO
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Zip | 80934-3088
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Country | US
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Telephone | 239-839-9842
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Fax | 865-500-3729
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Authorized Official
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Title or Position | MG MEMBER
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Name | MRS. HEATHER S HARVEY
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Credential | PT, OCS, MTC
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Telephone | 239-839-9842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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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 | 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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