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Organization
PREMIER PHYSICAL THERAPY & SPORTS MEDICINE
Active
Organization
PREMIER PHYSICAL THERAPY & SPORTS MEDICINE
Active
Parent organization
PREMIER PHYSICAL THERAPY & SPORTS MEDICINE
Organization subpart
Yes
Provider details
NPI number
Legal business name
PREMIER PHYSICAL THERAPY & SPORTS MEDICINE
Authorized official
JEFFREY ALAN TUCKER (OWNER)
(772) 335-7966
Entity
Organization
Contact information
Practice address
4007 SW PORT ST LUCIE BLVD STE 6, PORT SAINT LUCIE, FL 34953-5679
(772) 335-7966
Mailing address
PO BOX 8600, PORT SAINT LUCIE, FL 34985-8600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/16/2020
Last updated
01/16/2020
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