Organization
COUNTRY CLUB PT PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY NOLIN MPT (OWNER/THERAPIST)
(561) 632-2160
Entity
Organization
Contact information
Practice address
13200 EASTPOINTE WAY, WEST PALM BEACH, FL 33418-1418
(561) 632-2160
(561) 842-6458
Mailing address
513 US HIGHWAY 1 STE 216, NORTH PALM BEACH, FL 33408-4905
(561) 632-2160
(561) 842-6458
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT20257
FL
Other
Enumeration date
09/10/2010
Last updated
09/18/2012
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