Provider Demographics
NPI:1871249433
Name:ASP THERAPY SERVICES
Entity Type:Organization
Organization Name:ASP THERAPY SERVICES
Other - Org Name:ALL TOGETHER WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:QUARTANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-318-8041
Mailing Address - Street 1:14286 BEACH BLVD STE 19-222
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32250-1561
Mailing Address - Country:US
Mailing Address - Phone:904-450-5061
Mailing Address - Fax:866-730-7983
Practice Address - Street 1:14286 BEACH BLVD STE 19-222
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32250-1561
Practice Address - Country:US
Practice Address - Phone:904-450-5061
Practice Address - Fax:866-730-7983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024279600Medicaid