Organization
LEGACY HEALHCARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE CARTER (CREDENTIALING SPECIALIST)
(919) 327-9674
Entity
Organization
Contact information
Practice address
3050 WOODMONT AVE, WINTER HAVEN, FL 33884-3800
(863) 875-6584
Mailing address
3050 WOODMONT AVE, WINTER HAVEN, FL 33884-3800
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT 04827
FL
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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