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General NPI Number Information
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NPI Number | 1902757842
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Entity Type | Organization
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Legal Business Name | BODY & SOUL PHYSICAL THERAPY AND WELLNESS PLLC
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Dates
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Enumeration Date | 02/06/2026
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 620 SE CENTRAL PKWY
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City | STUART
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State | FL
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Zip | 34994-3970
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Country | US
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Telephone | 805-555-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 620 SE CENTRAL PKWY
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City | STUART
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State | FL
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Zip | 34994-3970
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DONALD MCCREA
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Credential |
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Telephone | 805-555-1212
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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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