Organization
OCTOPIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF PARKS PHYSICAL THERAPIST (LEAD PHYSICAL THERAPIST OWNER)
(904) 562-8571
Entity
Organization
Contact information
Practice address
1304 16TH AVE N, JACKSONVILLE BEACH, FL 32250-3777
(904) 562-8571
(904) 246-4602
Mailing address
1304 16TH AVE N, JACKSONVILLE BEACH, FL 32250-3777
(904) 562-8571
(904) 246-4602
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
OT-8953
FL
273Y00000X
Rehabilitation Hospital Unit
Primary
OT-8953
FL
283X00000X
Rehabilitation Hospital
OT-8953
FL
Other
Enumeration date
09/14/2015
Last updated
09/14/2015
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