Provider Demographics
NPI:1285979773
Name:PHYSICAL THERAPY CENTER OF ST. CROIX, LLC
Entity type:Organization
Organization Name:PHYSICAL THERAPY CENTER OF ST. CROIX, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CABRAL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:340-227-8801
Mailing Address - Street 1:PO BOX 6236
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00823-6236
Mailing Address - Country:US
Mailing Address - Phone:340-227-8801
Mailing Address - Fax:
Practice Address - Street 1:BEESTON HILL MEDICAL CENTER
Practice Address - Street 2:SUITE 1A BOX 4010
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00821
Practice Address - Country:US
Practice Address - Phone:340-227-8801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI91225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty