| NPI | 1104114412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY ONTIVEROS Owner 512-218-6955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1173628) |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2023-01-12 |