| NPI | 1053184291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASTON CASEY Owner 817-734-4732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261Q00000X Clinic/Center | |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2023-10-31 |
| Last Update Date | 2023-10-31 |