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NPI Code Detail

MEDICARE: WHITE SANDS PHYSICAL THERAPY INC

MEDICARE: WHITE SANDS PHYSICAL THERAPY INC
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/Center250750708034FL

General Provider Information

NPI Number : 1780652941
Entity Type Code : Organization
Provider Name (Legal Business Name) : WHITE SANDS PHYSICAL THERAPY INC
Provider Business Mailing Address
First Line : 600 OPP DRIVE
Second Line :
City : FT. WALTON BEACH
State : FL
Zip : 32548-4493
Country : US
Telephone Number : 850-301-1935
Fax Number : 850-301-1937
Provider Business Practice Location Address
First Line : 600 OPP DRIVE
Second Line :
City : FT. WALTON BEACH
State : FL
Zip : 32548-4493
Country : US
Telephone Number : 850-301-1935
Fax Number : 850-301-1937
Authorized Official
Title or Position : DIRECTOR
Name : ROBERT P MANN
Credential : PT OCS
Telephone Number : 850-301-1935
Provider Enumeration Date : 03/14/2006
Last Update Date : 04/02/2013

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Directions to “WHITE SANDS PHYSICAL THERAPY INC ” Practice Location

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