Provider Demographics
NPI:1609157494
Name:PHYSICAL THERAPY SPECIALTIES INC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY SPECIALTIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY-JO
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, PT, AP
Authorized Official - Phone:561-723-6733
Mailing Address - Street 1:10803 WHARTON WAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412-1113
Mailing Address - Country:US
Mailing Address - Phone:561-776-7170
Mailing Address - Fax:561-776-7171
Practice Address - Street 1:8645 N MILITARY TRL
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-6294
Practice Address - Country:US
Practice Address - Phone:561-776-7170
Practice Address - Fax:561-776-7171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT2048261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy