NPI | 1952072993 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARLES WILLIS Owner/Provider 214-623-0550 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
Additional Taxonomies | 111N00000X Chiropractor |
207LP2900X Anesthesiology, Pain Medicine | |
Enumeration Date | 2021-09-21 |
Last Update Date | 2021-09-21 |