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1104306257
JISSA THAYIL
GEORGETOWN, TX
NPI
1104306257
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2251G0304X Physical Therapist Geriatrics
(Licence: TX 1165213)
Enumeration Date
2018-08-17
Last Update Date
2018-08-17
Business Address
JISSA THAYIL
2406 BROOKHOLLOW TER
GEORGETOWN, TX 78626-7684
Phone number: 183-262-0316
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Mailing Address
JISSA THAYIL
2406 BROOKHOLLOW TER
GEORGETOWN, TX 78626-7684
Phone number:
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