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Organization
EXTREME SPORTS MEDICINE & REHABILITATION INC
Active
Organization
EXTREME SPORTS MEDICINE & REHABILITATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAN WILLIAMS MPT (PRESIDENT)
(954) 665-7326
Entity
Organization
Contact information
Practice address
14125 NW 80TH AVE STE 203, MIAMI LAKES, FL 33016-2351
(305) 381-5357
(305) 846-9653
Mailing address
4393 SW 130TH AVE, DAVIE, FL 33330-4730
(954) 665-7326
(305) 846-9653
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/01/2013
Last updated
08/14/2019
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