| NPI | 1659600922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANICE AMY MITCHELL Owner 254-699-3933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 64088001) |
| Enumeration Date | 2009-12-16 |
| Last Update Date | 2009-12-16 |