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Organization
MIDLAND PHYSICAL THERAPY AND SPORTS REHABILITATION INC
Active
Organization
MIDLAND PHYSICAL THERAPY AND SPORTS REHABILITATION INC
Active
Other names
Midland Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA STREETER (CHIEF ADMINISTRATIVE OFFICER)
(800) 699-9395
Entity
Organization
Contact information
Practice address
2420 W ILLINOIS AVE, MIDLAND, TX 79701-6337
(432) 687-0235
(432) 570-8713
Mailing address
PO BOX 932184, ATLANTA, GA 31193-2184
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT158345
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82979T
BLUE CROSS BLUE SHIELDS
TX
Enumeration date
05/30/2007
Last updated
07/09/2024
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