Provider Demographics
NPI:1801195532
Name:PREMIER RACING INSTITUE
Entity Type:Organization
Organization Name:PREMIER RACING INSTITUE
Other - Org Name:PRECISION PERFORMANCE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CORBO
Authorized Official - Suffix:
Authorized Official - Credentials:LPT
Authorized Official - Phone:813-901-0082
Mailing Address - Street 1:6101 WEBB RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-2872
Mailing Address - Country:US
Mailing Address - Phone:813-901-0082
Mailing Address - Fax:813-343-2390
Practice Address - Street 1:6101 WEBB RD
Practice Address - Street 2:SUITE 109
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-2872
Practice Address - Country:US
Practice Address - Phone:813-901-0082
Practice Address - Fax:813-343-2390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 15056261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy