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1831816263
MACIE ROSE SOUTHARD
WICHITA FALLS, TX
NPI
1831816263
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: TX 2173083)
Enumeration Date
2022-10-26
Last Update Date
2022-10-26
Business Address
MACIE ROSE SOUTHARD PTA
4309 OLD JACKSBORO HWY STE 101
WICHITA FALLS, TX 76302-2700
Phone number: 940-386-1004
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Mailing Address
MACIE ROSE SOUTHARD PTA
4309 OLD JACKSBORO HWY STE 101
WICHITA FALLS, TX 76302-2700
Phone number: 940-386-1004
Copy
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