| NPI | 1841314093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELIA ELISABETH VICENCIO Manager 915-859-1838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1096667) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |