Organization
PHYSICAL THERAPY WELLNESS GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SPERANCIA ANNA WHITE DPT (PHYSICAL THERAPIST/OWNER)
(772) 209-1183
Entity
Organization
Contact information
Practice address
519 SW NAGLE PLACE, PORT SAINT LUCIE, FL 34953
(772) 209-1183
Mailing address
10380 SW VILLAGE CENTER DR # 355, PORT SAINT LUCIE, FL 34987-1931
(772) 209-1183
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261Q00000X
—
FL
Enumeration date
06/07/2019
Last updated
05/23/2020
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