Provider Demographics
NPI:1306502604
Name:X3 PERFORMANCE AND PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:X3 PERFORMANCE AND PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:ISAAC
Authorized Official - Suffix:
Authorized Official - Credentials:PT, CSCS
Authorized Official - Phone:606-324-0540
Mailing Address - Street 1:1212 BATH AVE STE 350
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-2696
Mailing Address - Country:US
Mailing Address - Phone:606-324-0540
Mailing Address - Fax:606-324-0616
Practice Address - Street 1:14561 JETPORT LOOP;
Practice Address - Street 2:BUILDING #200, SUITE 135
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913
Practice Address - Country:US
Practice Address - Phone:606-324-0540
Practice Address - Fax:606-324-0616
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IRONTON PHYSICAL THERAPY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty