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General NPI Number Information
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NPI Number | 1871945147
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY INSTITUTE AND AQUATIC REHAB INC
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Dates
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Enumeration Date | 07/11/2016
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Last Update Date | 10/03/2016
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Provider Practice Location Address
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Address Line | 7447 N UNIVERSITY DR
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City | TAMARAC
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State | FL
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Zip | 33321-2970
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Country | US
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Telephone | 954-613-8283
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Fax | 954-345-6903
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Provider Business Mailing Address
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Address Line | 4971 LE CHALET BLVD SUITE 100
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-1418
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Country | US
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Telephone | 561-733-5590
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN PAPA
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Credential | D.C.
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Telephone | 561-801-2535
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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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