Organization
ACTIVEFIT REHAB PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RATREE LERTKITCHAROENPON PT,DPT (PRESIDENT & COO)
(386) 451-2185
Entity
Organization
Contact information
Practice address
4649 CLYDE MORRIS BLVD UNIT 607, PORT ORANGE, FL 32129-3003
(386) 214-2663
Mailing address
4649 CLYDE MORRIS BLVD UNIT 607, PORT ORANGE, FL 32129-3003
(386) 214-2663
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT13789
FL
Other
Enumeration date
03/14/2017
Last updated
06/28/2017
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