| NPI | 1770611519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL DEMARK VICENCIO Administrator 915-881-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1096667) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2008-06-17 |