Organization
VITAL REHABILITATION LLC.
Active
Other names
Vital Sports and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER AMANDA JUSTICE DPT, SCS (OWNER, CLINICIAN)
(904) 657-0089
Entity
Organization
Contact information
Practice address
3600 PEORIA RD STE 203, ORANGE PARK, FL 32065-7686
(904) 657-0089
(904) 560-5283
Mailing address
2216 GREEN HERON CT, FLEMING ISLAND, FL 32003-8600
(904) 434-5737
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
225700000X
Massage Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA38374
MASSAGE THERAPY
FL
Enumeration date
12/01/2014
Last updated
01/31/2024
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