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NPI Code Detail

MEDICARE: COMPASS PHYSICAL THERAPY

MEDICARE: COMPASS PHYSICAL THERAPY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2000XPhysical Therapy Clinic/CenterPTA 20956FL

General Provider Information

NPI Number : 1134307986
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPASS PHYSICAL THERAPY
Provider Business Mailing Address
First Line : 807 N TYNDALL PKWY
Second Line :
City : CALLAWAY
State : FL
Zip : 32404-9495
Country : US
Telephone Number : 850-763-0505
Fax Number : 850-763-0966
Provider Business Practice Location Address
First Line : 807 N TYNDALL PKWY
Second Line :
City : CALLAWAY
State : FL
Zip : 32404-9495
Country : US
Telephone Number : 850-763-0505
Fax Number : 850-763-0966
Authorized Official
Title or Position : OWNER
Name : MRS. JENNIFER VONMAACK
Credential :
Telephone Number : 850-763-0505
Provider Enumeration Date : 02/04/2008
Last Update Date : 02/04/2008

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Directions to “COMPASS PHYSICAL THERAPY ” Practice Location

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