Dynamic Pain and Wellness Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

DYNAMIC PAIN AND WELLNESS PHYSICAL THERAPY, LLC

Practice address

930 Mar Walt Drive
Fort Walton Beach, FL 32547-6706

Phone

(850) 226-6801

Fax

(877) 413-5104

NPI assigned

Oct 26, 2017

Last updated

Oct 26, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mathew McCune, MDNPI 1457493611

Title

Ceo

Phone

(850) 226-6801

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mathew McCune, M.D.

  • Anesthesiology Physician
  • Fort Walton Beach, FL
  • NPI 1457493611
  Authorized official Same address or phone

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508976000000",
    "number": "1700398070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 MAR WALT DRIVE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476706",
            "telephone_number": "850-226-6801",
            "fax_number": "877-413-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 MAR WALT DRIVE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476706",
            "telephone_number": "850-226-6801",
            "fax_number": "877-413-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC PAIN AND WELLNESS PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-26",
        "last_updated": "2017-10-26",
        "status": "A",
        "authorized_official_last_name": "MCCUNE",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-226-6801",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destini Dupree
• Marian Duran
• Shannon Dyer, SLP
• Elizabeth Brooke Dylewski
• Dynamic Pain & Wellness LLC
• Dawn Ellen Dziokonski, RN, NCSN
• Toree Easterwood
• Christina Eberle, OT
• Ec Advanced Practice Nursing PLLC (Realm Midlife & Menopause Medicine)
• Ec Therapeutic Services LLC (EC Therapy)

• Physical Therapist in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.