Organization
CLUB 50, LLC
Active
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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