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ACTIVE LIFESTYLES WELLNESS & PERFORMANCE CTR

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GIORGIO G RES D.C., P.T. (OWNER)
(772) 978-7379
Entity
Organization

Contact information

Practice address
1715 37TH PL, THIRD FLOOR, VERO BEACH, FL 32960-4502
(772) 978-7379
(772) 539-8515
Mailing address
1715 37TH PL, THIRD FLOOR, VERO BEACH, FL 32960-4502
(772) 978-7379
(772) 539-8515

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH9113
FL
225100000X
Physical Therapist
Primary
PT22446
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
60994
BCBS- DR. RES
FL
01
77915
BCBS GROUP #
FL
Enumeration date
05/28/2006
Last updated
02/13/2018
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