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Organization
PHYSICARE ANCILLARY SERVICE CORPORATION
Active
Organization
PHYSICARE ANCILLARY SERVICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUKE JASON HAYNES P.T. (DIRECTOR)
(817) 594-9200
Entity
Organization
Contact information
Practice address
925 SANTA FE DR, SUITE 111, WEATHERFORD, TX 76086-5866
(817) 594-9200
Mailing address
PO BOX 2306, WEATHERFORD, TX 76086-7306
(817) 594-9200
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
26048050564
TX
Other
Enumeration date
07/10/2007
Last updated
07/10/2007
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