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General NPI Number Information
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NPI Number | 1497463863
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Entity Type | Organization
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Legal Business Name | TOTAL GOAL PHYSIO LLC
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Dates
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Enumeration Date | 11/14/2022
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Last Update Date | 09/17/2023
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Provider Practice Location Address
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Address Line | 4719 NW 44TH CT
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City | TAMARAC
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State | FL
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Zip | 33319-3614
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Country | US
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Telephone | 954-873-1634
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Fax |
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Provider Business Mailing Address
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Address Line | 4719 NW 44TH CT
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City | TAMARAC
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State | FL
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Zip | 33319-3614
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Country | US
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Telephone | 954-873-1634
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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 | SHEANA ANN GARBUTT
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Credential | DPT
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Telephone | 954-873-1634
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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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