| NPI | 1437646767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL HEARNE Physical Therapist 936-465-6282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 09007R) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 08870R) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2018-04-23 |