Organization
MUSCLE INJECTION THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT PENDLETON (MANAGER)
(772) 249-9450
Entity
Organization
Contact information
Practice address
10692 S US HIGHWAY 1, SUITE C, PORT ST LUCIE, FL 34952-6408
(772) 249-9450
Mailing address
P O BOX 8902, SUITE C, PORT ST LUCIE, FL 34985
(772) 249-9450
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AP1293
FL
208VP0014X
Interventional Pain Medicine Physician
Primary
AP1293
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP1293
ACUPUNCTURE
FL
Enumeration date
05/11/2015
Last updated
10/19/2015
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