Provider Demographics
NPI:1861457301
Name:IN-TOWN PHYSICAL THERP & REHAB INC
Entity Type:Organization
Organization Name:IN-TOWN PHYSICAL THERP & REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST OWNER DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SYLVESTER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:561-588-5737
Mailing Address - Street 1:25 S FEDERAL HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460
Mailing Address - Country:US
Mailing Address - Phone:561-588-5737
Mailing Address - Fax:561-588-5003
Practice Address - Street 1:25 S FEDERAL HIGHWAY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460
Practice Address - Country:US
Practice Address - Phone:561-588-5737
Practice Address - Fax:561-588-5003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT0005247225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY912VBCBSOtherBLUE CROSS BLUE SHIELD
FLY3824Medicare ID - Type Unspecified