Provider Demographics
NPI:1366196297
Name:NOVA THERAPY SPECIALISTS
Entity type:Organization
Organization Name:NOVA THERAPY SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL/THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:WICKS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:941-921-5809
Mailing Address - Street 1:1055 S TAMIAMI TRAIL SUITE 105
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-9118
Mailing Address - Country:US
Mailing Address - Phone:941-921-5809
Mailing Address - Fax:941-921-5249
Practice Address - Street 1:1055 S TAMIAMI TRAIL SUITE 105
Practice Address - Street 2:SUITE 105
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-9118
Practice Address - Country:US
Practice Address - Phone:941-921-5809
Practice Address - Fax:941-921-5249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty