| NPI | 1710012208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT L LARSON Clinic Director 817-923-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1043453) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1065415) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-08-22 |