Organization
PRIME SPORTS PERFORMANCE AND THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK BLANK (SOLE MBR)
(321) 436-8247
Entity
Organization
Contact information
Practice address
550 HERITAGE DR STE 204, JUPITER, FL 33458-3029
(321) 436-8247
Mailing address
550 HERITAGE DR STE 204, JUPITER, FL 33458-3029
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
07/23/2024
Last updated
07/23/2024
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