Provider Demographics
NPI:1164776662
Name:AUSTRALIAN PHYSIOTHERAPY SPECIALISTS, LLC
Entity Type:Organization
Organization Name:AUSTRALIAN PHYSIOTHERAPY SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MARROW
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-403-3880
Mailing Address - Street 1:4745 SUTTON PARK CT
Mailing Address - Street 2:SUITE 803
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-0250
Mailing Address - Country:US
Mailing Address - Phone:904-337-1090
Mailing Address - Fax:904-337-1093
Practice Address - Street 1:4745 SUTTON PARK CT
Practice Address - Street 2:SUITE 803
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-0250
Practice Address - Country:US
Practice Address - Phone:904-337-1090
Practice Address - Fax:904-337-1093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19660225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty