Provider Demographics
NPI:1932149267
Name:PRECISION PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:PRECISION PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:WOLSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-726-1460
Mailing Address - Street 1:24945 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-3927
Mailing Address - Country:US
Mailing Address - Phone:727-726-1460
Mailing Address - Fax:727-724-9705
Practice Address - Street 1:24945 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-3927
Practice Address - Country:US
Practice Address - Phone:727-726-1460
Practice Address - Fax:727-724-9705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1147Medicare ID - Type Unspecified