| NPI | 1386132132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE LACKEY Managing Member 817-370-9891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2020-08-31 |