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Organization
SOUTH WALTON PHYSICAL THERAPY AND REHABILITATION, INC
Active
Organization
SOUTH WALTON PHYSICAL THERAPY AND REHABILITATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID V MONTELEONE (CEO)
(850) 267-9010
Entity
Organization
Contact information
Practice address
4942 US HIGHWAY 98 W STE 6, SANTA ROSA BEACH, FL 32459-4092
(850) 267-9010
(850) 267-0677
Mailing address
4942 US HIGHWAY 98 W STE 6, SANTA ROSA BEACH, FL 32459-4092
(850) 267-9010
(850) 267-0677
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3883
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7446067
JESS'S AETNA PROV#
FL
01
—
RG5
SRB BCBS PROV#
FL
01
—
RR2
DFS BCBS PROV#
FL
Enumeration date
12/27/2006
Last updated
08/22/2020
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