JUSTIN PROVO

Physical Therapist

Active Individual
NPI: 1588553259

Practice Address

2200 W EAU GALLIE BLVD STE 105
Melbourne, FL 32935

Phone: (255) 255-2818

Specialties

Specialty Code Primary License
Physical Therapist 225100000X Yes PT43362 (FL)

Frequently Asked Questions

NPI 1588553259 is the National Provider Identifier for JUSTIN PROVO, a Physical Therapist provider located in Melbourne, FL. This NPI was enumerated on June 30, 2025.
JUSTIN PROVO practices at 2200 W EAU GALLIE BLVD STE 105, Melbourne, FL 32935.

Quick Facts

NPI
1588553259
Type
Individual
Enumerated
Jun 30, 2025
Last Updated
Aug 7, 2025

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