Organization
GE SPINE ORTHOPEDIC SPORTS THERAPY CENTER LLC
Active
Organization
GE SPINE ORTHOPEDIC SPORTS THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGAR COMSON PENANO RPT (PRESIDENT)
(941) 268-5577
Entity
Organization
Contact information
Practice address
7331 COLLEGE PKWY STE 230, FORT MYERS, FL 33907-5524
(941) 268-5577
Mailing address
7331 COLLEGE PKWY STE 230, FORT MYERS, FL 33907-5524
(941) 268-5577
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT0007217
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT0007217
FL PT
FL
Enumeration date
02/04/2013
Last updated
02/04/2013
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