| NPI | 1750100723 |
|---|---|
| Doing Business As | PRESTIGE SPORTS AND REGENERATIVE MEDICINE LLC |
| Doing Business As | PRESTIGE CONCIERGE PT-OT-SLP AND RT |
| Entity Type | Organization |
| Authorized Contact | EMIR KHATTAK Credentialing Manager 469-485-3166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2024-10-07 |
| Last Update Date | 2024-10-14 |