Provider Demographics
NPI:1467970277
Name:NAPLES PREMIER PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:NAPLES PREMIER PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:239-575-7833
Mailing Address - Street 1:770 ANDERSON DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-2811
Mailing Address - Country:US
Mailing Address - Phone:239-575-7833
Mailing Address - Fax:813-512-8237
Practice Address - Street 1:3940 PROSPECT AVE STE 103
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-3745
Practice Address - Country:US
Practice Address - Phone:239-575-7833
Practice Address - Fax:813-512-8237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-31
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty