| NPI | 1013036508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA SUE BRELAND Manager 940-569-3630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 640900000) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OK OK2429) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2011-07-26 |