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General NPI Number Information
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NPI Number | 1588069579
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Entity Type | Organization
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Legal Business Name | THE KIDD CHOICE THERAPY INC
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Dates
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Enumeration Date | 11/03/2014
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Last Update Date | 11/03/2014
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Provider Practice Location Address
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Address Line | 27335 SW 142ND AVE
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City | HOMESTEAD
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State | FL
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Zip | 33032-8854
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Country | US
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Telephone | 786-662-9003
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Fax |
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Provider Business Mailing Address
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Address Line | 27335 SW 142ND AVE
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City | HOMESTEAD
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State | FL
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Zip | 33032-8854
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Country | US
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Telephone | 786-662-9003
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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. ROBERT JAMES KIDD
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Credential | DPT
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Telephone | 786-662-9003
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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 | PT25083
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License Number State | FL
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