Organization
SEA RANCH PHYSICAL THERAPY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI M RICHARDSON PT (PRESIDENT)
(954) 785-4776
Entity
Organization
Contact information
Practice address
103400 OVERSEAS HWY, STE 111, KEY LARGO, FL 33037-2834
(954) 785-4776
(954) 785-9789
Mailing address
103400 OVERSEAS HWY, STE 111, KEY LARGO, FL 33037-2834
(954) 785-4776
(954) 785-9789
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT3855
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y916B
BLUE SHIELD PROVIDER #
FL
Enumeration date
02/13/2007
Last updated
08/09/2013
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