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Organization
EVOLVE THERAPY AND WELLNESS PLLC
Active
Organization
EVOLVE THERAPY AND WELLNESS PLLC
Active
Other names
Evolve Therapy and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
SOURACHACK S SANANIKONE DPT (OWNER)
(850) 418-0014
Entity
Organization
Contact information
Practice address
209 S A ST, PENSACOLA, FL 32502-5554
(850) 533-0266
(850) 807-5446
Mailing address
2786 INVERNESS PARK DR, GULF BREEZE, FL 32563-3049
(850) 418-0014
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/25/2023
Last updated
04/05/2023
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