Providian Functional Capacity Specialists
NPI #1013258862 in Green Cove Springs, Florida
Provider Information
- NPI Number
- 1013258862
- Entity Type
- Organization
- Organization Name
- Providian Functional Capacity Specialists
- Primary Specialty
- Clinic/Center - Physical Therapy
- Enumeration Date
- Mar 4, 2013
- Last Updated
- Mar 4, 2013
Practice Location
- Address
- 716 N ORANGE AVE
- State
- Florida
- ZIP Code
- 32043-2920
- Phone
- (888) 957-3337
Authorized Official
- Name
- MR. BRIAN SCOTT IMLER, BA, A.T.,C/L
- Title
- PRESIDENT
- Phone
- (904) 982-5762
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Physical Therapy — Physical Therapy |
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