Provider Demographics
NPI:1093948135
Name:LIVING LARGE THERAPEUTICS LLC
Entity Type:Organization
Organization Name:LIVING LARGE THERAPEUTICS LLC
Other - Org Name:EMILY SCHAEFFER LARGE PT
Other - Org Type:Other Name
Authorized Official - Title/Position:P.T.
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:LARGE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:561-762-3105
Mailing Address - Street 1:PO BOX 1311
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33402-1311
Mailing Address - Country:US
Mailing Address - Phone:561-762-3105
Mailing Address - Fax:
Practice Address - Street 1:718 KANUGA DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-7222
Practice Address - Country:US
Practice Address - Phone:561-762-3105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19954225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1992870059OtherINDIVIDUAL NPI NUMBER
FLY0899BOtherMEDICARE IDENTIFICATION NUMBER