| NPI | 1619678042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC DEANDA Physical Therapist 817-386-4144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2023-04-14 |