# BACK ON TRACK PHYSICAL THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700192689
- **Authorized official:** JULIE KIRBY (MPT)
- **Authorized official phone:** (941) 726-5392

## Contact information

- **Practice address:** 9080 WOODSTORK CT, VENICE, FL 34293-7614
- **Practice address phone:** (941) 412-4465
- **Mailing address:** 9080 WOODSTORK CT, VENICE, FL 34293-7614
- **Mailing address phone:** (941) 412-4465

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | PT22716 | FL | Yes |

## Other

- **Enumeration date:** 08/30/2010
- **Last updated:** 03/21/2013