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General NPI Number Information
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NPI Number | 1811143282
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Entity Type | Organization
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Legal Business Name | P3T LLC
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Dates
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Enumeration Date | 08/17/2008
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Last Update Date | 08/17/2008
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Provider Practice Location Address
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Address Line | 121 ORCHIS RD
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-6521
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Country | US
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Telephone | 904-806-5583
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Fax | 904-797-9711
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Provider Business Mailing Address
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Address Line | 121 ORCHIS RD
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-6521
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Country | US
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Telephone | 904-806-5583
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Fax | 904-797-9711
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Authorized Official
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Title or Position | MGR
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Name | BRUCE D CATHCART
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Credential | MPT
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Telephone | 904-806-5583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT18230
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License Number State | FL
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