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Organization
PRO VITA PHYSICAL THERAPY LLC
Active
Organization
PRO VITA PHYSICAL THERAPY LLC
Active
Parent organization
PRO VITA PHYSICAL THERAPY, LLC
Other names
Pro Vita Physical Therapy-FWB, Pro Vita Physical Therapy - Shalimar
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRO VITA PHYSICAL THERAPY, LLC
Authorized official
CARLA J BULLA (OWNER)
(850) 331-3017
Entity
Organization
Contact information
Practice address
411 RACETRACK RD NE, FORT WALTON BEACH, FL 32547-2503
(850) 331-3017
(855) 978-1838
Mailing address
279 TEXAS PKWY, CRESTVIEW, FL 32536-2125
(850) 331-3017
(855) 975-2575
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
02/10/2022
Last updated
08/24/2026
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