Organization
DYNAMIC THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BERNADETTE CHUA OCAMPOS RPT (VICE-PRESIDENT)
(863) 648-2333
Entity
Organization
Contact information
Practice address
4734 EXPLORATION AVE, LAKELAND, FL 33812-3319
(863) 648-2333
(863) 648-2888
Mailing address
4734 EXPLORATION AVE, LAKELAND, FL 33812-3319
(863) 648-2333
(863) 648-2888
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT10695
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y8050
BCBS PROVIDER NUMBER
FL
Enumeration date
11/07/2006
Last updated
05/13/2008
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