| NPI | 1164567483 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | GREGORY T. OTTERMAN Owner 210-308-7473  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1170429)  | 
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 6583)  | 
| Enumeration Date | 2007-02-21 | 
| Last Update Date | 2025-09-11 |