Organization
PT & SPINAL REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL JOSEPH THOMAS PT (OWNER)
(352) 735-4385
Entity
Organization
Contact information
Practice address
17521 US HIGHWAY 441, MOUNT DORA, FL 32757-6737
(352) 735-4385
(352) 735-4386
Mailing address
17521 US HIGHWAY 441, MOUNT DORA, FL 32757-6737
(352) 735-4385
(352) 735-4386
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT27107
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942608187
MEDICARE INDIVIDUAL NPI
FL
Enumeration date
06/17/2015
Last updated
06/17/2015
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