Provider Demographics
NPI:1205115144
Name:ALLIN PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:ALLIN PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:PANCHO
Authorized Official - Last Name:GAJO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:407-608-9189
Mailing Address - Street 1:10395 NARCOOSSEE RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-6939
Mailing Address - Country:US
Mailing Address - Phone:407-608-9189
Mailing Address - Fax:407-482-4575
Practice Address - Street 1:10395 NARCOOSSEE RD
Practice Address - Street 2:SUITE E
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6939
Practice Address - Country:US
Practice Address - Phone:407-608-9189
Practice Address - Fax:407-482-4575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy