| NPI | 1922107820 |
|---|---|
| Doing Business As | THE SPORT CLINIC |
| Entity Type | Organization |
| Authorized Contact | CHARLES MICHAEL SHAPIRO President 954-989-5255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT2021) |
| 225100000X Physical Therapist (Licence: FL PT19559) | |
| 225100000X Physical Therapist (Licence: FL PT22241) | |
| 225100000X Physical Therapist (Licence: FL PT32161) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2013-01-08 |