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Organization
POTENTIA THERAPEUTICS, LLC
Active
Organization
POTENTIA THERAPEUTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRICE BROUSSARD ROSE (OWNER)
(813) 374-9508
Entity
Organization
Contact information
Practice address
2307 S DALE MABRY HWY STE F, TAMPA, FL 33629-6322
(813) 374-9508
(813) 443-5599
Mailing address
2307 S DALE MABRY HWY STE F, TAMPA, FL 33629-6322
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/25/2018
Last updated
04/30/2018
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