Organization
RIDE THE WAVE THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANA SANFORD-HELLER (OWNER)
(352) 256-0658
Entity
Organization
Contact information
Practice address
150 SOUTHPARK BLVD STE 202, SAINT AUGUSTINE, FL 32086-5179
(904) 217-3103
Mailing address
247 PORTADA DR, SAINT AUGUSTINE, FL 32095-1637
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/18/2020
Last updated
09/18/2020
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