| NPI | 1467041194 |
|---|---|
| Former Legal Business Name | FORGE THE ATHLETE |
| Entity Type | Organization |
| Authorized Contact | LYANNE COLON Doctor Of Physical Therapy 832-350-6322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-01-17 |
| Last Update Date | 2021-05-19 |