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General NPI Number Information
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NPI Number | 1770635393
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC RESOURCES INC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5450 W HILLSBORO BLVD SUITE NINE
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City | COCONUT CREEK
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State | FL
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Zip | 33073-4317
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Country | US
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Telephone | 954-725-9125
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Fax | 954-725-9135
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Provider Business Mailing Address
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Address Line | 5450 W HILLSBORO BLVD STE # 9
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City | COCONUT CREEK
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State | FL
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Zip | 33073-4317
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Country | US
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Telephone | 954-725-9125
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Fax | 954-725-9135
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | MR. JOSEPH WILLIAM RUSINOWSKI JR.
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Credential | PT
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Telephone | 954-725-9125
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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 | PT2586
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License Number State | FL
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