Provider Demographics
NPI:1710178306
Name:JIM HARTTS PHYSICAL THERAPY AND SPORTS TRAINING CENTER INC
Entity Type:Organization
Organization Name:JIM HARTTS PHYSICAL THERAPY AND SPORTS TRAINING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JIM
Authorized Official - Last Name:HARTT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:954-202-5959
Mailing Address - Street 1:251 W PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3925
Mailing Address - Country:US
Mailing Address - Phone:954-202-5959
Mailing Address - Fax:954-202-5544
Practice Address - Street 1:251 W PROSPECT RD
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-3925
Practice Address - Country:US
Practice Address - Phone:954-202-5959
Practice Address - Fax:954-202-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7721261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy