Provider Demographics
NPI:1932122132
Name:PEOPLES PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:PEOPLES PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:FEATHERHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:321-610-7978
Mailing Address - Street 1:494 N HARBOR CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-6858
Mailing Address - Country:US
Mailing Address - Phone:321-610-7978
Mailing Address - Fax:321-610-7979
Practice Address - Street 1:494 N HARBOR CITY BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-6858
Practice Address - Country:US
Practice Address - Phone:321-610-7978
Practice Address - Fax:321-610-7979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0004495225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4833Medicare ID - Type Unspecified