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General NPI Number Information
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NPI Number | 1780732594
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Entity Type | Organization
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Legal Business Name | TOTAL LYMPHEDEMA CARE INC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 03/03/2008
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Provider Practice Location Address
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Address Line | 275 NW 107TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-4061
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Country | US
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Telephone | 954-438-5655
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Fax |
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Provider Business Mailing Address
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Address Line | 275 NW 107TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-4061
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Country | US
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Telephone | 954-438-5655
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. JEAN A. YZER
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Credential |
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Telephone | 954-438-5655
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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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