Provider Demographics
NPI:1205455888
Name:PANACEAS THERAPY CARE, LLC
Entity type:Organization
Organization Name:PANACEAS THERAPY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:III
Authorized Official - Credentials:DPT, CSCS
Authorized Official - Phone:941-276-5710
Mailing Address - Street 1:6 CAYMAN CT
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-2003
Mailing Address - Country:US
Mailing Address - Phone:941-276-5710
Mailing Address - Fax:
Practice Address - Street 1:6 CAYMAN CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-2003
Practice Address - Country:US
Practice Address - Phone:941-276-5710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-13
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty