Organization
OPTIMIZE PHYSICAL THERAPY AND SPORTS PERFORMANCE, LLC
Active
Other names
Optimize Physical Therapy and Sports Performance, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN JACOB EVANICH PT, DPT, OCS (PRESIDENT)
(219) 805-1184
Entity
Organization
Contact information
Practice address
3030 POWERS AVE, JACKSONVILLE, FL 32207-8043
(219) 805-1184
Mailing address
4941 WHITE BLUFF DR, JACKSONVILLE, FL 32225-1115
(219) 805-1184
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/25/2020
Last updated
10/25/2020
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