Organization
DIRECT THERAPY SERVICES LLC
Active
Organization
DIRECT THERAPY SERVICES LLC
Active
Other names
Alliance Foundation of FL, INC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDOLPH L KERNON II (VICE PRESIDENT)
(386) 257-4400
Entity
Organization
Contact information
Practice address
595 N WILLIAMSON BLVD, DAYTONA BEACH, FL 32114-7185
(386) 257-4400
(386) 257-4372
Mailing address
595 N WILLIAMSON BLVD, DAYTONA BEACH, FL 32114-7185
(386) 257-4400
(386) 257-4372
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
227800000X
Certified Respiratory Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
09/24/2007
Last updated
02/04/2008
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