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Organization
PRACTICAL REHAB LLC
Active
Organization
PRACTICAL REHAB LLC
Active
Other names
PhysioCare Sport & Spine
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE POLANCO (PT/OWNER)
(813) 395-0018
Entity
Organization
Contact information
Practice address
4019 HENDERSON BLVD, TAMPA, FL 33629-4939
(813) 395-0018
(917) 601-7515
Mailing address
4019 HENDERSON BLVD, TAMPA, FL 33629-4939
(813) 395-0018
(917) 601-7515
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
08/09/2019
Last updated
08/09/2019
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