Organization
FOREVER ACTIVE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY PUGLISI PT, DPT (PRESIDENT)
(732) 575-3275
Entity
Organization
Contact information
Practice address
10 RIDGE RD, PALM COAST, FL 32137-9808
(732) 575-3275
Mailing address
10 RIDGE RD, PALM COAST, FL 32137-9808
(732) 575-3275
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/11/2022
Last updated
10/11/2022
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