Provider Demographics
NPI:1811143282
Name:P3T LLC
Entity type:Organization
Organization Name:P3T LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:D
Authorized Official - Last Name:CATHCART
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:904-806-5583
Mailing Address - Street 1:121 ORCHIS RD
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-6521
Mailing Address - Country:US
Mailing Address - Phone:904-806-5583
Mailing Address - Fax:904-797-9711
Practice Address - Street 1:121 ORCHIS RD
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-6521
Practice Address - Country:US
Practice Address - Phone:904-806-5583
Practice Address - Fax:904-797-9711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-17
Last Update Date:2008-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT18230261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy