Provider Demographics
NPI:1790554467
Name:INHER PHYSIQUE LLC
Entity Type:Organization
Organization Name:INHER PHYSIQUE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTINE
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:ROPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-483-0586
Mailing Address - Street 1:1108 AIRPORT BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8623
Mailing Address - Country:US
Mailing Address - Phone:850-483-0586
Mailing Address - Fax:
Practice Address - Street 1:4657 GULF BREEZE PKWY STE A&B
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-9166
Practice Address - Country:US
Practice Address - Phone:850-483-0586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INHER PHYSIQUE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy