Organization
CALEB YOUNGBLOOD P.T. INC
Active
Other names
caleb youngblood p.t. inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CALEB LUCAS YOUNGBLOOD DPT (PRESIDENT)
(772) 285-4984
Entity
Organization
Contact information
Practice address
10701 S OCEAN DR LOT 888, JENSEN BEACH, FL 34957-2641
(772) 285-4984
Mailing address
10701 S OCEAN DR LOT 888, JENSEN BEACH, FL 34957-2641
(772) 285-4984
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT24611
LICENSE
FL
Enumeration date
07/10/2019
Last updated
07/10/2019
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