Organization Name: | FITNESS QUEST-PORT CHARLOTTE LLC |
NPI Number: | 1679761696 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MACKENZIE M BARTRUFF (VICE-PRESIDENT) |
Mailing Address: | 4161 Tamiami Trl Suite 103 Port Charlotte |
State: | FL US |
Postal Code: | 339529204 |
Phone Number: | 9417436700 |
Fax Number: | 9417436707 |
NPI Enumeration Date: | 10/04/2007 |
NPI Last Update Date: | 09/03/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT22121 |
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 |