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NPI Code Detail

MEDICARE: DAVIS PHYSICAL THERAPY P.A.

MEDICARE: DAVIS PHYSICAL THERAPY P.A.
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
1225100000XPhysical TherapistPT25261FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11992771851OTHERFLNPI

General Provider Information

NPI Number : 1770980237
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVIS PHYSICAL THERAPY P.A.
Provider Business Mailing Address
First Line : 227 TADCASTER CT
Second Line :
City : SAINT JOHNS
State : FL
Zip : 32259-7256
Country : US
Telephone Number : 904-287-9969
Fax Number :
Provider Business Practice Location Address
First Line : 7685 103RD ST
Second Line : SUITE 1
City : JACKSONVILLE
State : FL
Zip : 32210-9325
Country : US
Telephone Number : 904-771-1116
Fax Number :
Authorized Official
Title or Position : CEO
Name : MR. STEPHEN T DAVIS
Credential : P.T
Telephone Number : 904-287-9969
Provider Enumeration Date : 11/28/2014
Last Update Date : 11/28/2014

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Directions to “DAVIS PHYSICAL THERAPY P.A. ” Practice Location

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