| Organization Name: | PHYSICAL THERAPY AND REHABILITATION CLINIC INC |
| NPI Number: | 1487081345 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUSTIN WELDON (PRESIDENT) |
| Mailing Address: | 319 W Call St Starke |
| State: | FL US |
| Postal Code: | 320913113 |
| Phone Number: | 9043861257 |
| Fax Number: | 9043681258 |
| NPI Enumeration Date: | 10/08/2013 |
| NPI Last Update Date: | 10/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |