Organization · NPI-2

850 Therapy, LLC

Speech-Language Pathologist, · Crestview, FL

NPI number1013783711
StatusActive
Last updated in NPPESDec 4, 2023

Details

NPI
1013783711
Entity type
Organization (NPI-2)
Legal business name
850 Therapy, LLC
Organization subpart
No
Enumeration date
Dec 4, 2023
Certification date
Dec 4, 2023
Last updated
Dec 4, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,––Yes
261QX0100X Clinic/Center, Occupational Medicine––
261QP2000X Clinic/Center, Physical Therapy––

Practice location

124 John King Rd
Crestview, FL 32539-8306

Phone 850-634-6020

Mailing address

124 John King Rd
Crestview, FL 32539-8306

Phone 850-634-6020

Authorized official

Gabrielle Brooks-Griffith
President
8506346020

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