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Organization
OPTIMAL PERFORMANCE AND PHYSICAL THERAPIES BAYSIDE LLC
Active
Organization
OPTIMAL PERFORMANCE AND PHYSICAL THERAPIES BAYSIDE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETH PATTERSON PT (OWNER)
(727) 475-5540
Entity
Organization
Contact information
Practice address
73 N PARK PLACE BLVD STE 102, CLEARWATER, FL 33759-3917
(727) 475-5540
Mailing address
6023 HAMMOCK WOODS DR, ODESSA, FL 33556-3330
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT4616
PT LICENSE
FL
Enumeration date
12/16/2018
Last updated
12/16/2018
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