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Organization
PTAC PLLC
Active
Organization
PTAC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE MARCHESE (PRACTICE ADMINISTRATOR)
(214) 205-4995
Entity
Organization
Contact information
Practice address
456 E SANDY LAKE RD STE 110, COPPELL, TX 75019-2911
(972) 393-8067
(972) 638-8567
Mailing address
456 E SANDY LAKE RD STE 110, COPPELL, TX 75019-2911
(972) 393-8067
(972) 638-8567
Taxonomy
Speciality
Code
Description
License number
State
2251E1300X
Clinical Electrophysiology Physical Therapist
Primary
—
—
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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