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General NPI Number Information
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NPI Number | 1801362629
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Entity Type | Organization
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Legal Business Name | FAMILY PHYSICAL THERAPY INCORPORATED
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Dates
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Enumeration Date | 10/18/2018
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Last Update Date | 10/18/2018
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Provider Practice Location Address
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Address Line | 745 FORESTERIA AVE
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City | WELLINGTON
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State | FL
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Zip | 33414-8202
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Country | US
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Telephone | 561-723-6886
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Fax |
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Provider Business Mailing Address
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Address Line | 745 FORESTERIA AVE
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City | WELLINGTON
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State | FL
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Zip | 33414-8202
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Country | US
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Telephone | 561-723-6892
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TERESA KELLY
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Credential |
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Telephone | 561-723-6892
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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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