| NPI | 1912902511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN ELIZABETH FOURTON Director 972-860-8649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX 00T89Z) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2020-08-22 |