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General NPI Number Information
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NPI Number | 1689957490
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Entity Type | Organization
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Legal Business Name | MANUS PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 12/26/2012
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Provider Practice Location Address
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Address Line | 900 E INDIANTOWN RD SUITE 111
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City | JUPITER
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State | FL
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Zip | 33477-5165
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Country | US
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Telephone | 561-288-8810
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Fax | 877-464-1813
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Provider Business Mailing Address
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Address Line | 900 E INDIANTOWN RD SUITE 111
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City | JUPITER
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State | FL
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Zip | 33477-5165
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Country | US
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Telephone | 561-288-8810
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Fax | 877-464-1813
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. DIANA JOHNSON-FORD
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Credential | DPT
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Telephone | 561-288-8810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 8829
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License Number State | FL
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