| NPI | 1053996652 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | AVERY DALTON President 832-723-8347 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy | 
| Additional Taxonomies | 225100000X Physical Therapist | 
| Enumeration Date | 2021-03-15 | 
| Last Update Date | 2024-11-04 |