Organization
CALEB YOUNGBLOOD P.T. INC
Active
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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