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Organization
RENEW PHYSICAL THERAPY INC
Active
Organization
RENEW PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI JOHNSON (AGENT)
(321) 537-9311
Entity
Organization
Contact information
Practice address
325 5TH AVE, SUITE 103, INDIALANTIC, FL 32903-4273
(321) 537-2657
Mailing address
PO BOX 33099, INDIALANTIC, FL 32903-0099
(321) 956-0485
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
11/10/2015
Last updated
01/14/2016
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