| NPI | 1174653695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN D. KLEMENT Owner 903-813-1551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX 649440000) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 649440000) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2015-09-29 |