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General NPI Number Information
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NPI Number | 1770204703
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Entity Type | Organization
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Legal Business Name | ARTS AND ATHLETICS PHYSICAL THERAPY
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Dates
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Enumeration Date | 09/07/2022
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Last Update Date | 09/07/2022
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Provider Practice Location Address
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Address Line | 106 JULINGTON PLAZA DR UNIT 5
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City | ST JOHNS
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State | FL
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Zip | 32259-6317
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Country | US
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Telephone | 804-221-1273
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Fax |
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Provider Business Mailing Address
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Address Line | 106 JULINGTON PLAZA DR UNIT 5
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City | ST JOHNS
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State | FL
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Zip | 32259-6317
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Country | US
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Telephone | 804-221-1273
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EMILY GRACE BECKER
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Credential | PT
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Telephone | 804-221-1273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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