| NPI | 1700215050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA BERNADETTE OLMOS Physical Therapist Assistant 915-867-2434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: TX 2099951) |
| Additional Taxonomies | 251E00000X Home Health (Licence: TX 2099951) |
| 251K00000X Public Health or Welfare (Licence: TX 2099951) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 2099951) | |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2013-11-07 |