Organization
PVPT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY C PARKS (VICE PRESIDENT)
(904) 725-1657
Entity
Organization
Contact information
Practice address
880 A1A N, STE 18A, PONTE VEDRA BEACH, FL 32082-3220
(904) 285-2910
(904) 285-4663
Mailing address
PO BOX 48116, JACKSONVILLE, FL 32247-8116
(904) 725-1657
(904) 725-7247
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
06/17/2006
Last updated
08/31/2007
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