Doctor Name: | GLENN BARDITCH |
NPI Number: | 1033318027 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | PT21474 |
Business Practice Address: | 7000 Sw 62nd Ave Suite 120 South Miami, FL - 331434716 |
Business Phone Number: | 3056667116 |
Business Fax Number: | 3056656069 |
Mailing Address: | 10500 Sw 108th Ter, MIAMI |
State: | FL |
Postal Code: | 331763451 |
Phone Number: | 3052719186 |
Fax Number: | |
NPI Enumeration Date: | 07/11/2007 |
NPI Last Update Date: | 08/29/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT21474 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |