| NPI | 1124020979 |
|---|---|
| Former Legal Business Name | SUSAN G. ROBERSON |
| Entity Type | Organization |
| Authorized Contact | DAVID ALAN ROBERSON Manager 817-473-4684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 658850000) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2014-11-20 |