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Organization
MOBILE PHYSICAL THERAPY
Active
Organization
MOBILE PHYSICAL THERAPY
Active
Other names
Granbury Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE ANN TOUT (OFFICE MANAGER)
(817) 573-8204
Entity
Organization
Contact information
Practice address
1301 PALUXY RD, GRANBURY, TX 76048-5663
(817) 573-8204
(817) 573-8472
Mailing address
1301 PALUXY RD, GRANBURY, TX 76048-5663
(817) 573-8204
(817) 573-8472
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
627890000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7047011
AETNA
TX
01
—
83294T
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/08/2007
Last updated
09/02/2010
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