Organization
FUNCTIONAL THERAPY AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANE H. ROSONINA DPT (DOCTOR OF PHYSICAL THERAPY)
(321) 202-3323
Entity
Organization
Contact information
Practice address
2715 KNOX MCRAE DR, TITUSVILLE, FL 32780-5113
(321) 202-3323
Mailing address
2715 KNOX MCRAE DR, TITUSVILLE, FL 32780-5113
(321) 202-3323
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
04/16/2020
Last updated
04/27/2020
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