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Organization
TALLAHASSEE ORTHOPEDIC & SPORTS PHYSICAL THERAPY
Active
Organization
TALLAHASSEE ORTHOPEDIC & SPORTS PHYSICAL THERAPY
Active
Other names
Crawfordville Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KENT KNISLEY P.T. (OWNER)
(850) 926-8855
Entity
Organization
Contact information
Practice address
2887 CRAWFORDVILLE HIGHWAY, DUBREJA PLAZA, SUITE 3, CRAWFORDVILLE, FL 32327
(850) 926-8555
(850) 926-2402
Mailing address
PO BOX 13269, TALLAHASSEE, FL 32317-3269
(850) 219-1520
(850) 219-1521
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
FL
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376593053
PARENT FACILITY NPI
FL
01
—
883224200
PARENT FACILITY MEDICAID
FL
05
—
883224201
—
FL
Enumeration date
03/07/2007
Last updated
07/02/2009
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