Provider Demographics
NPI:1992260723
Name:ACUTE INURY PHYSICAL THERAPY CENTERS LLC
Entity type:Organization
Organization Name:ACUTE INURY PHYSICAL THERAPY CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:KNISLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, ATC, CLCP
Authorized Official - Phone:850-545-5318
Mailing Address - Street 1:6438 HEARTLAND CIR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-7509
Mailing Address - Country:US
Mailing Address - Phone:850-545-5318
Mailing Address - Fax:
Practice Address - Street 1:6438 HEARTLAND CIR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-7509
Practice Address - Country:US
Practice Address - Phone:850-545-5318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy