Basic Information
| Provider Information | |||||||||
| NPI: | 1336247014 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THERAPY & SPORTS CENTER, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7746 | ||||||||
| Address2: | |||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337347746 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278985001 | ||||||||
| FaxNumber: | 7278940554 | ||||||||
| Practice Location | |||||||||
| Address1: | 412 12TH AVE N | ||||||||
| Address2: | |||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337011120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278985001 | ||||||||
| FaxNumber: | 7278940554 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 09/16/2020 | ||||||||
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| AuthorizedOfficialLastName: | HUTCHINS | ||||||||
| AuthorizedOfficialFirstName: | DEBBIE | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7278985001 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| NPICertificationDate: | 09/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT 1891 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.