Organization
AXISPRO PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MACIEJ MOLIK P.T (OWNER/MANAGER)
(321) 514-2844
Entity
Organization
Contact information
Practice address
405 N WICKHAM RD, SUITE 103, MELBOURNE, FL 32935-8628
(321) 802-3130
Mailing address
645 NEWPORT DR, INDIALANTIC, FL 32903-4030
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT 27353
FL
Other
Enumeration date
05/02/2016
Last updated
09/19/2016
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