# INNOVATIVE PHYSICAL THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568472082
- **Authorized official:** CHRISTINA ENER (ADMINISTRATOR)
- **Authorized official phone:** (361) 855-8004

## Contact information

- **Practice address:** 4455 S PADRE ISLAND DR STE 8, CORPUS CHRISTI, TX 78411-5166
- **Practice address phone:** (361) 855-8004
- **Practice address fax:** (361) 986-0751
- **Mailing address:** 4455 S PADRE ISLAND DR STE 8, CORPUS CHRISTI, TX 78411-5166
- **Mailing address phone:** (361) 855-8004
- **Mailing address fax:** (361) 986-0751

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | OT107558 | TX | Yes |

## Other

- **Enumeration date:** 08/08/2006
- **Last updated:** 08/22/2020