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Organization
SPACE COAST THERAPY AND WELLNESS
Active
Organization
SPACE COAST THERAPY AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON BRISCOE PT, DPT, MTC, CFC (PRESIDENT)
(561) 351-8430
Entity
Organization
Contact information
Practice address
801 E HIBISCUS BLVD STE 1, MELBOURNE, FL 32901-3252
(321) 802-5665
Mailing address
801 E HIBISCUS BLVD STE 1, MELBOURNE, FL 32901-3252
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/07/2019
Last updated
05/07/2019
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