Provider Demographics
NPI:1255162897
Name:SANFORD PELVIC THERAPY AND WELLNESS LLC
Entity type:Organization
Organization Name:SANFORD PELVIC THERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-973-7674
Mailing Address - Street 1:202 DELESPINE DR
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-3008
Mailing Address - Country:US
Mailing Address - Phone:407-973-7674
Mailing Address - Fax:
Practice Address - Street 1:890 N BOUNDARY AVE # 202
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-3173
Practice Address - Country:US
Practice Address - Phone:352-396-6280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty