| NPI | 1487906020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHYLA BURRELL Credentialing Coordinator 888-590-4002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 620940005) |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2016-06-16 |