| NPI | 1407066574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER A RUSSELL Physical Therapist Owner 817-741-8122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1110955) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |