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Organization
PRIME PHYSICAL THERAPY INC
Active
Organization
PRIME PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROBIN LYNN JOHNSON (OWNER)
(813) 932-3315
Entity
Organization
Contact information
Practice address
4895 W WATERS AVE, SUITE E, TAMPA, FL 33634-1316
(813) 932-3315
Mailing address
PO BOX 272689, TAMPA, FL 33688-2689
(813) 932-3315
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
222535
—
FL
01
—
2906996
CIGNA
FL
01
—
350376000
DEPT OF LABOR
FL
01
—
Y0571
NON-PAR BCBS
FL
Enumeration date
05/31/2007
Last updated
10/28/2015
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