# 65 PLUS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** 65 Plus Physical Therapy - Country Club Physical Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205292489
- **Authorized official:** MATTHEW CORN DPT (PRESIDENT)
- **Authorized official phone:** (941) 451-6691

## Contact information

- **Practice address:** 1978 TAMIAMI TRL S, SUITE 5 & 6, VENICE, FL 34293-5006
- **Practice address phone:** (941) 451-6607
- **Practice address fax:** (941) 451-2028
- **Mailing address:** 350 W VENICE AVE \# 1946, VENICE, FL 34285-0001
- **Mailing address phone:** (941) 451-6691
- **Mailing address fax:** (941) 451-2028

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251G0304X | Geriatric Physical Therapist | 21464 | FL | Yes |

## Other

- **Enumeration date:** 01/04/2016
- **Last updated:** 06/14/2016