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Organization
PREMIER PHYSICAL THERAPY & SPORTS MEDICINE
Active
Organization
PREMIER PHYSICAL THERAPY & SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY ALAN TUCKER MPT (EXECUTIVE DIRECTOR)
(772) 335-7966
Entity
Organization
Contact information
Practice address
2222 S HARBOR CITY BLVD STE 530, MELBOURNE, FL 32901-5591
(772) 335-7966
Mailing address
PO BOX 8600, PORT ST LUCIE, FL 34985-8600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
02/19/2020
Last updated
02/19/2020
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