=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588859409
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | C.H.O.O.S.E. PHYSICAL THERAPY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2007
-----------------------------------------------------
Last Update Date | 11/19/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 29605 US HIGHWAY 19 N STE 150
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33761-1538
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-797-7600
-----------------------------------------------------
Fax | 727-797-7655
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 29605 US HIGHWAY 19 N. CRITERION CENTER SUITE 150
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33761-3142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-797-7600
-----------------------------------------------------
Fax | 727-797-7655
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | MRS. AMY W WELSH
-----------------------------------------------------
Credential | MS PT, OCS
-----------------------------------------------------
Telephone | 727-797-7600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------