Provider Demographics
NPI:1104925791
Name:VLAAR INTERNATIONAL PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:VLAAR INTERNATIONAL PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHANNES
Authorized Official - Middle Name:M
Authorized Official - Last Name:VLAAR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:561-740-4555
Mailing Address - Street 1:1520 10TH AVE N STE B
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-2069
Mailing Address - Country:US
Mailing Address - Phone:561-740-4555
Mailing Address - Fax:866-248-3592
Practice Address - Street 1:1520 10TH AVE N STE B
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-2069
Practice Address - Country:US
Practice Address - Phone:561-740-4555
Practice Address - Fax:866-248-3592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-07-21
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
FLK3357Medicare UPIN