MEDICARE: DELRAY PHYSICAL THERAPY PA

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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1942518295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELRAY PHYSICAL THERAPY PA

Provider Business Mailing Address
First Line	:	PO BOX 480427
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33448-0427
Country	:	US
Telephone Number	:	561-455-2195
Fax Number	:	561-455-2207

Provider Business Practice Location Address
First Line	:	1911 S FEDERAL HWY
Second Line	:	SUITE 400
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-3331
Country	:	US
Telephone Number	:	561-455-2195
Fax Number	:	561-455-2207

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAN GOODMAN
Credential	:	DC
Telephone Number	:	561-455-2195

Provider Enumeration Date	:	09/21/2010
Last Update Date	:	10/05/2010

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Directions to “DELRAY PHYSICAL THERAPY PA ” Practice Location

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