Provider Demographics
NPI:1285289389
Name:IDEAL PHYSICAL THERAPY AND FITNESS LLC
Entity type:Organization
Organization Name:IDEAL PHYSICAL THERAPY AND FITNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DRUMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-983-1397
Mailing Address - Street 1:8595 COLLIER BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114-3556
Mailing Address - Country:US
Mailing Address - Phone:781-983-1397
Mailing Address - Fax:239-228-7486
Practice Address - Street 1:8595 COLLIER BLVD STE 115
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-3556
Practice Address - Country:US
Practice Address - Phone:781-983-1397
Practice Address - Fax:239-228-7486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy