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Organization
LAKE WORTH PHYSICAL THERAPY INC
Active
Organization
LAKE WORTH PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NOEL S SISON PT (PRESIDENT)
(561) 317-1374
Entity
Organization
Contact information
Practice address
3400 JOG RD, GREENACRES, FL 33467-2080
(561) 317-1374
(561) 641-3909
Mailing address
3400 JOG RD, GREENACRES, FL 33467-2080
(561) 317-1374
(561) 641-3909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT12925
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y905J
BLUE CROSS BLUE SHIELD GR
FL
Enumeration date
08/31/2006
Last updated
08/22/2020
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