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Organization
HOUSE OF ATHLETE TAMPA LLC
Active
Organization
HOUSE OF ATHLETE TAMPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE MCKAY ESQ (CREDENTIALING SPECIALIST)
(813) 601-9036
Entity
Organization
Contact information
Practice address
6912 ASPHALT AVE, TAMPA, FL 33614-3625
(262) 488-0118
Mailing address
6912 ASPHALT AVE, TAMPA, FL 33614-3625
(262) 488-0118
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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