| NPI | 1861764722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURENCE JUAREZ Administrator 915-842-0504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: TX 1147100) |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2012-02-07 |