Organization
ACTIVE LIVING REHABILITATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS R WEST (BUSINESS MANAGER)
(727) 376-4012
Entity
Organization
Contact information
Practice address
10446 PONTOFINO CIR, TRINITY, FL 34655
(727) 376-4012
(727) 375-7878
Mailing address
10446 PONTOFINO CIR, TRINITY, FL 34655-7057
(727) 376-4012
(727) 375-7878
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
05/07/2007
Last updated
04/13/2010
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