Provider Demographics
NPI:1457066813
Name:PT360HEALTH LLC
Entity type:Organization
Organization Name:PT360HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAGRUTI
Authorized Official - Middle Name:RAMESHBHAI
Authorized Official - Last Name:HIRANI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:310-739-1843
Mailing Address - Street 1:8922 JASPERS DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-2433
Mailing Address - Country:US
Mailing Address - Phone:310-739-1843
Mailing Address - Fax:
Practice Address - Street 1:8922 JASPERS DR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-2433
Practice Address - Country:US
Practice Address - Phone:310-739-1843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty