Organization
DYNAMIK BALANCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARISSA MARVETTE WILLIAMS PT (FOUNDER)
(813) 541-6880
Entity
Organization
Contact information
Practice address
10506 MARSANNE PL, RIVERVIEW, FL 33578-4319
(813) 541-6880
Mailing address
10506 MARSANNE PL, RIVERVIEW, FL 33578-4319
(813) 541-6880
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
PT21423
FL
Other
Enumeration date
12/16/2012
Last updated
12/16/2012
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