| NPI | 1750374187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE LYNN WEAVER Owner 903-596-8999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 649620000) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2020-08-22 |