| NPI | 1629016068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNIE C STOUT Owner 915-252-5320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 657650000) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 554090000) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2020-08-22 |