Organization
CLUB 50, LLC
Active
Other names
Fyzical Therapy and Balance Center, Fyzical
Organization subpart
No
Provider details
NPI number
Authorized official
KEEFE CHARLES FUGLEBERG P.T. (OWNER)
(941) 951-0170
Entity
Organization
Contact information
Practice address
1727 2ND ST STE 2, SARASOTA, FL 34236-8524
(941) 951-0170
(941) 993-1088
Mailing address
1727 2ND ST STE 2, SARASOTA, FL 34236-8524
(941) 951-0170
(941) 993-1088
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
990010114743
FL
Other
Enumeration date
02/04/2015
Last updated
11/20/2018
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