| NPI | 1114212065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANA FULENWIDER President 214-884-9695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: TX 670770000) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2011-06-17 |