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General NPI Number Information
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NPI Number | 1699969683
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Entity Type | Organization
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Legal Business Name | AT HOME PT SERVICES LLC
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Dates
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Enumeration Date | 09/01/2007
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Last Update Date | 12/10/2014
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Provider Practice Location Address
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Address Line | 25211 ROLAND LN
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City | PUNTA GORDA
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State | FL
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Zip | 33955-4219
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Country | US
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Telephone | 954-554-5803
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Fax |
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Provider Business Mailing Address
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Address Line | 25211 ROLAND LN
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City | PUNTA GORDA
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State | FL
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Zip | 33955-4219
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Country | US
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Telephone | 954-554-5803
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | SUSAN T. SITZBERGER
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Credential | PT
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Telephone | 954-554-5803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PT0002384
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License Number State | FL
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