Basic Information
| Provider Information | |||||||||
| NPI: | 1265783898 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACTION PHYSICAL THERAPY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4971 LE CHALET BLVD STE 100 | ||||||||
| Address2: | 100 | ||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334361418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617335590 | ||||||||
| FaxNumber: | 5617400714 | ||||||||
| Practice Location | |||||||||
| Address1: | 3345 BURNS RD | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | PALM BEACH GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334104324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5615784850 | ||||||||
| FaxNumber: | 5613453063 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2012 | ||||||||
| LastUpdateDate: | 12/11/2020 | ||||||||
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| AuthorizedOfficialLastName: | PAPA | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5618012535 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | D.C. | ||||||||
| NPICertificationDate: | 12/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.