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General NPI Number Information
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NPI Number | 1801537386
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Entity Type | Organization
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Legal Business Name | CONCIERGE PT VIP LLC
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Dates
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Enumeration Date | 04/06/2022
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Last Update Date | 04/06/2022
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Provider Practice Location Address
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Address Line | 3077 WATERSIDE CIR
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-6401
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Country | US
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Telephone | 315-525-6860
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Fax |
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Provider Business Mailing Address
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Address Line | 3077 WATERSIDE CIR
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-6401
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Country | US
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Telephone | 315-525-6860
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Fax |
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Authorized Official
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Title or Position | OWNER AND CEO
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Name | DR. JOSEPH JAMES MARTIN
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Credential | PT, DPT, OCS
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Telephone | 315-525-6860
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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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