Provider Demographics
NPI:1851726012
Name:PHYSICAL THERAPY SPECIALISTS OF HUNTERS CREEK, LLC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY SPECIALISTS OF HUNTERS CREEK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAWCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-601-3922
Mailing Address - Street 1:14115 TOWN LOOP BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-4839
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14115 TOWN LOOP BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-4839
Practice Address - Country:US
Practice Address - Phone:407-601-3922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-06
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20492261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy