Organization
PEACE RIVER PHYSICAL THERAPY & REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE D DOEBLE MSPT (AMBR)
(941) 888-4561
Entity
Organization
Contact information
Practice address
2200 KINGS HWY UNIT 2F, PORT CHARLOTTE, FL 33980-5760
(941) 888-4561
(941) 347-4695
Mailing address
PO BOX 510326, PUNTA GORDA, FL 33951-0326
(941) 888-4561
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
11/27/2018
Last updated
07/28/2020
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