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General NPI Number Information
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NPI Number | 1780209759
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Entity Type | Organization
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Legal Business Name | ESSENTIAL PT, LLC
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Dates
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Enumeration Date | 06/15/2020
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Last Update Date | 06/15/2020
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Provider Practice Location Address
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Address Line | 11412 SAND HILL AVE
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City | SPRING HILL
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State | FL
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Zip | 34608-3050
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Country | US
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Telephone | 863-663-6952
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Fax |
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Provider Business Mailing Address
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Address Line | 11412 SAND HILL AVE
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City | SPRING HILL
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State | FL
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Zip | 34608-3050
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Country | US
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Telephone | 863-663-6952
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DR. MICHELINA ELIZABETH RICHARDSON
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Credential | PT, DPT
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Telephone | 863-663-6952
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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 |
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License Number State |
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