| NPI | 1770676199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN MARY THIBODEAUX HASLAM Owner 903-297-0008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1143816) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2020-08-22 |