| NPI | 1861118481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GYNA ALEXANDRA VALENZUELA Manager Member 903-707-8099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2022-10-14 |
| Last Update Date | 2022-10-14 |