Organization
PRIZM HEALTHCARE SERVICES PA
Active
Organization
PRIZM HEALTHCARE SERVICES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM REGAN PHYSICAL THERAPIST (PRESIDENT AND DIRECTOR)
(904) 806-6403
Entity
Organization
Contact information
Practice address
229 GOLDEN OAKS LN, ST AUGUSTINE, FL 32080-6111
(661) 476-7051
(904) 471-8569
Mailing address
229 GOLDEN OAKS LN, ST AUGUSTINE, FL 32080-6111
(904) 806-6403
(904) 471-8569
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
08/15/2019
Last updated
08/20/2020
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