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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