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General NPI Number Information
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NPI Number | 1699045062
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Entity Type | Organization
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Legal Business Name | HEALTHWORKS PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 01/03/2012
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 1060 6TH AVE
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City | VERO BEACH
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State | FL
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Zip | 32960-5922
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Country | US
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Telephone | 772-299-3383
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Fax | 772-299-3367
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Provider Business Mailing Address
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Address Line | 4240 5TH ST
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City | VERO BEACH
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State | FL
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Zip | 32968-1963
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Country | US
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Telephone | 772-299-3383
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RONALD KEITH WILSON
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Credential | PT
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Telephone | 772-299-3383
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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 | PT2969
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License Number State | FL
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