Organization
H2O-4-LIFE AQUATIC AND BALANCE REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA VANSALISBURY (CEO)
(941) 539-2403
Entity
Organization
Contact information
Practice address
108 BELLA VERDE BLVD, NOKOMIS, FL 34275-1100
(941) 539-2403
Mailing address
3545 MASSINI AVE, NORTH PORT, FL 34286-2412
(941) 539-2403
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
02/08/2024
Last updated
02/08/2024
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