| Entity Name: | FUNCTIONAL FREEDOM PHYSICAL THERAPY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 18 Apr 2022 (3 years ago) |
| Document Number: | L22000183120 |
| FEI/EIN Number | 88-2134153 |
| Address: | 4388 JACK POWELL RD., CRESTVIEW, FL 32539 |
| Mail Address: | 4388 JACK POWELL RD., CRESTVIEW, FL 32539 |
| ZIP code: | 32539 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225775869 | 2022-05-16 | 2022-05-16 | 4388 JACK POWELL RD, CRESTVIEW, FL, 325398238, US | 4388 JACK POWELL RD, CRESTVIEW, FL, 325398238, US | |||||||||||||
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| Phone | +1 850-758-6844 |
Authorized person
| Name | AMBER BLOCKER |
| Role | OWNER |
| Phone | 8507586844 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BLOCKER, AMBER C | Agent | 4388 JACK POWELL RD., CRESTVIEW, FL 32539 |
| Name | Role | Address |
|---|---|---|
| BLOCKER, AMBER C | Authorized Representative | 4388 JACK POWELL RD., CRESTVIEW, FL 32539 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-04 |
| ANNUAL REPORT | 2023-02-01 |
| Florida Limited Liability | 2022-04-18 |
Date of last update: 12 Feb 2025
Sources: Florida Department of State
