Organization
OVERCOMERS REHAB & PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY R ELSE (OWNER/PRESIDENT)
(321) 757-0626
Entity
Organization
Contact information
Practice address
18 W AVENUE B STE 4, MELBOURNE, FL 32901-1219
(321) 757-0626
(321) 757-0323
Mailing address
1126 WOODSMERE PKWY, ROCKLEDGE, FL 32955-4408
(321) 757-0626
(321) 757-0323
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT12961
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018931400
—
FL
Enumeration date
07/22/2011
Last updated
11/23/2018
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