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1053775379
BLAZE JIMS MAMMEN
ALLEN, TX
NPI
1053775379
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: TX 1270540)
Enumeration Date
2016-04-12
Last Update Date
2016-04-12
Business Address
-- BLAZE JIMS MAMMEN
2035 W MCDERMOTT DR STE 460
ALLEN, TX 75013-4733
Phone number: 214-289-6159
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Mailing Address
-- BLAZE JIMS MAMMEN
305 NE LOOP 820 BUSINESS TOWER 1 ,SUITE 200
HURST, TX 76053-7209
Phone number: 817-292-8787
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