GREGORY SHANE DIRICKSON

BANGS, TX
NPI1376108704
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: TX  2128687)
Enumeration Date2019-05-01
Last Update Date2019-05-01
Business Address
GREGORY SHANE DIRICKSON LPTA
1105 E FITZGERALD ST
BANGS, TX 76823-3232
Phone number: 325-752-7682
Mailing Address
GREGORY SHANE DIRICKSON LPTA
2803 14TH ST
BROWNWOOD, TX 76801-7911
Phone number: 325-330-2370
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