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Organization
PHYSICAL THERAPY & SPORTS REHAB LLC
Active
Organization
PHYSICAL THERAPY & SPORTS REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD HENRY HOFFMAN (VICE PRESIDENT)
(561) 312-1120
Entity
Organization
Contact information
Practice address
1290 OLD CONGRESS AVE., WEST PALM BEACH, FL 33409
(561) 312-1120
(954) 622-9120
Mailing address
1290 OLD CONGRESS AVE., WEST PALM BEACH, FL 33409
(561) 312-1120
(954) 622-9120
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
PT21702
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF544Z
MEDICARE PTAN
FL
Enumeration date
03/08/2012
Last updated
03/08/2012
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