| NPI | 1952067050 |
|---|---|
| Doing Business As | ACTIVE HEALTHCARE AND PHYSICAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | DAVID BRADLEY Owner 817-282-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2021-11-12 |
| Last Update Date | 2021-11-12 |