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General NPI Number Information
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NPI Number | 1639576432
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY INSTITUTE AND AQUATIC REHAB INC.
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Dates
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Enumeration Date | 11/24/2014
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Last Update Date | 07/24/2015
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Provider Practice Location Address
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Address Line | 170 N UNIVERSITY DR
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6714
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Country | US
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Telephone | 786-272-5697
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Fax | 786-364-1552
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Provider Business Mailing Address
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Address Line | 4971 LE CHALET BLVD
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-1418
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Country | US
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Telephone | 561-733-5590
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Fax | 561-740-0714
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Authorized Official
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Title or Position | OWNER
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Name | JOHN PAPA
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Credential | D.C.
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Telephone | 561-801-2535
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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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