Organization
PRO-ACTIVE PHYSICAL THERAPY, INC.
Active
Organization
PRO-ACTIVE PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH HISAMOTO (PRACTICE ADMINISTRATOR)
(813) 979-4819
Entity
Organization
Contact information
Practice address
13801 BRUCE B DOWNS BLVD, SUITE 303, TAMPA, FL 33613-3946
(813) 979-4819
(813) 975-8708
Mailing address
13801 BRUCE B DOWNS BLVD STE 303, TAMPA, FL 33613-3939
(813) 979-4819
(813) 975-8708
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/11/2005
Last updated
04/04/2018
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