Organization
ACUPHYSIO360, LLC
Active
Other names
RECUPERY ACTIVE RECOVERY STUDIO
Organization subpart
No
Provider details
NPI number
Authorized official
PHUONG PHAM (MANAGER)
(954) 263-6019
Entity
Organization
Contact information
Practice address
245 WHEELHOUSE LN STE 1451, LAKE MARY, FL 32746-3696
(407) 878-0507
(844) 904-0880
Mailing address
245 WHEELHOUSE LN STE 1451, LAKE MARY, FL 32746-3696
(407) 878-0507
(844) 904-0880
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
—
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103490700
—
FL
Enumeration date
12/04/2019
Last updated
12/07/2021
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