NPI | 1417666884 |
---|---|
Entity Type | Organization |
Authorized Contact | MISTY S WILSON Contract & Credentialing Specialist 972-372-6779 |
Organization Subpart ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 225X00000X Occupational Therapist |
235Z00000X Speech-Language Pathologist, | |
Enumeration Date | 2022-11-15 |
Last Update Date | 2022-11-15 |