| NPI | 1417311028 |
|---|---|
| Doing Business As | ACTIVE LIFE PHYSICAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | MARIA CATHERINE YAZON CUSTODIO PT/Owner 972-984-7670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2016-04-09 |
| Last Update Date | 2022-10-14 |