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Organization
OPTIMAL PERFORMANCE AND PHYSICAL THERAPIES ST. PETERSBURG, LLC
Active
Organization
OPTIMAL PERFORMANCE AND PHYSICAL THERAPIES ST. PETERSBURG, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETH PATTERSON PT (MANAGER)
(813) 690-4414
Entity
Organization
Contact information
Practice address
2600 DR MARTIN LUTHER KING JR ST N STE 200B, ST PETERSBURG, FL 33704-2744
(727) 474-5580
Mailing address
21756 STATE ROAD 54 STE 102, LUTZ, FL 33549-2905
(727) 475-5580
(844) 213-8986
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT19911
PT LICENSE
FL
Enumeration date
12/19/2018
Last updated
12/09/2019
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