Provider Demographics
NPI:1730659632
Name:INCLINIC PHYSIO
Entity Type:Organization
Organization Name:INCLINIC PHYSIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:866-907-4797
Mailing Address - Street 1:8659 BAYPINE RD STE 304
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7554
Mailing Address - Country:US
Mailing Address - Phone:866-907-4797
Mailing Address - Fax:866-908-4797
Practice Address - Street 1:8659 BAYPINE RD STE 304
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7554
Practice Address - Country:US
Practice Address - Phone:866-907-4797
Practice Address - Fax:866-908-4797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-04
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty