Functional Freedom Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

FUNCTIONAL FREEDOM PHYSICAL THERAPY LLC

Practice address

4388 Jack Powell Rd
Crestview, FL 32539-8238

Phone

(850) 758-6844

NPI assigned

May 16, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Amber Blocker, DPT

Title

Owner

Phone

(850) 758-6844

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1225775869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4388 JACK POWELL RD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325398238",
            "telephone_number": "850-758-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4388 JACK POWELL RD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325398238",
            "telephone_number": "850-758-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL FREEDOM PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A",
        "authorized_official_last_name": "BLOCKER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-758-6844",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fresenius Vascular Care Pensacola LLC
• Fresenius Vascular Care Pensacola LLC
• Jessica Frye, ITDS
• Jordan Fuller
• Kristin Nicole Fuller
• Aalaysiah Gage
• Judith Leanette Gaither, RDMS
• Brittni Lynn Galigher
• Mayra Garcia
• Mary Joyce Garner, DNP MSN MSPH MPA

• Physical Therapist in Crestview, FL
• Providers in Crestview, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.