| NPI | 1760722839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK JEROME V. GONZALES President/ PT In Charge 915-408-0699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1123313) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 111483) |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2016-04-07 |