Organization
PHYSIO SPORTS MED, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK B VAN KOUWEN PT (PRESIDENT)
(908) 723-0876
Entity
Organization
Contact information
Practice address
1783 IMPERIAL PALM DR, APOPKA, FL 32712-2476
(908) 723-0876
Mailing address
1783 IMPERIAL PALM DR, APOPKA, FL 32712-2476
(908) 723-0876
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
27064
FL
Other
Enumeration date
05/23/2012
Last updated
05/23/2012
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