Provider Demographics
NPI:1528219342
Name:PHYSICAL THERAPY SOLUTIONS NEFL, INC.
Entity Type:Organization
Organization Name:PHYSICAL THERAPY SOLUTIONS NEFL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:GLASGOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-928-3303
Mailing Address - Street 1:4480 DEERWOOD LAKE PKWY
Mailing Address - Street 2:#144
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-2247
Mailing Address - Country:US
Mailing Address - Phone:904-928-3303
Mailing Address - Fax:904-928-3343
Practice Address - Street 1:8833 PERIMETER PARK BLVD
Practice Address - Street 2:SUITE 904
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1109
Practice Address - Country:US
Practice Address - Phone:904-928-3303
Practice Address - Fax:904-928-3343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEI193AOtherPTAN