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Organization
ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES LLC
Active
Organization
ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA ANNE ROULEAU PT, OCS (OWNER)
(863) 644-0007
Entity
Organization
Contact information
Practice address
4720 CLEVELAND HEIGHTS BLVD, SUITE 101, LAKELAND, FL 33813-2243
(863) 644-0007
(863) 644-3377
Mailing address
4720 CLEVELAND HEIGHTS BLVD, SUITE 101, LAKELAND, FL 33813-2243
(863) 644-0007
(863) 644-3377
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y917E
BCBS GROUP NUMBER
FL
Enumeration date
03/09/2006
Last updated
11/20/2007
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