Organization
BACK IN FORM PHYSICAL THERAPY INC.
Active
Organization
BACK IN FORM PHYSICAL THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL HAUSER (OWNER/PHYSICAL THERAPIST)
(772) 231-3676
Entity
Organization
Contact information
Practice address
4445 HIGHWAY A1A, SUITE 125, VERO BEACH, FL 32963-5405
(772) 231-3676
(772) 231-3670
Mailing address
4445 HIGHWAY A1A, SUITE 125, VERO BEACH, FL 32963-5405
(772) 231-3676
(772) 231-3670
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT18268
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT18268
STATE LICENSE
FL
01
—
PT18370
STATE LICENSE
FL
Enumeration date
08/18/2011
Last updated
08/18/2011
Update your record
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