| NPI | 1124034343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER DERMONT Clinic Supervisor 210-654-7428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 636700002) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2012-03-16 |