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Organization
VITAL REHABILITATION LLC.
Active
Organization
VITAL REHABILITATION LLC.
Active
Other names
Vital Sports and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER AMANDA JUSTICE DPT, SCS (OWNER, CLINICIAN)
(904) 657-0089
Entity
Organization
Contact information
Practice address
3600 PEORIA RD STE 203, ORANGE PARK, FL 32065-7686
(904) 657-0089
(904) 560-5283
Mailing address
2216 GREEN HERON CT, FLEMING ISLAND, FL 32003-8600
(904) 434-5737
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
225700000X
Massage Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA38374
MASSAGE THERAPY
FL
Enumeration date
12/01/2014
Last updated
01/31/2024
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