Organization
COUNTRY CLUB PHYSICAL THERAPY, LLC
Active
Organization
COUNTRY CLUB PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP CROMBIE DPT (PHYSICAL THERAPIST/OWNER)
(239) 280-1229
Entity
Organization
Contact information
Practice address
14529 INDIGO LAKES CIR, NAPLES, FL 34119-4811
(239) 280-1229
Mailing address
PO BOX 8838, NAPLES, FL 34101-8838
(239) 280-1229
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT11581
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT11581
FLORIDA PHYSICAL THERAPY LICENSE
FL
Enumeration date
11/28/2012
Last updated
11/28/2012
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