Organization
PLAY MOVE GROW PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTE K VAN DUYNE (MANAGER)
(321) 446-0064
Entity
Organization
Contact information
Practice address
2539 NORMA ST, TITUSVILLE, FL 32780-2845
(321) 446-0064
Mailing address
2539 NORMA ST, TITUSVILLE, FL 32780-2845
(321) 446-0064
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT 18971
FL
Other
Enumeration date
09/04/2015
Last updated
09/04/2015
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