| 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 |