| NPI | 1720028459 |
|---|---|
| Doing Business As | TIDEWAY PHYSICAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | KENDALL GILL Owner 817-929-1420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2021-09-10 |