| NPI | 1821090069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LOVELADY Business Manager 817-283-9435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 646300000) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 601960000) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2020-08-22 |