Provider Demographics
NPI:1023736550
Name:DKB HEALTH LLC FYZICAL THERAPY AND BALANCE CENTER
Entity type:Organization
Organization Name:DKB HEALTH LLC FYZICAL THERAPY AND BALANCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PLANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:277-388-4688
Mailing Address - Street 1:1136 19TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-4146
Mailing Address - Country:US
Mailing Address - Phone:727-504-5655
Mailing Address - Fax:
Practice Address - Street 1:4020 PARK ST N STE 101
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-4030
Practice Address - Country:US
Practice Address - Phone:727-388-4688
Practice Address - Fax:727-388-6887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-19
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy