| NPI | 1043767791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNIE HARDEN Managing Member 469-766-2698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX Q8500) |
| Additional Taxonomies | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: TX Q8500) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2018-09-28 |