| NPI | 1841664596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRADY CARTER Medical Director 817-370-6350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2015-11-18 |
| Last Update Date | 2017-03-20 |