| NPI | 1255790226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA JEAN LIGHTSEY Owner/Physical Therapist 979-446-0422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1145365) |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2018-06-16 |