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Organization
LIFELINE PEDIATRIC CLINICS
Active
Organization
LIFELINE PEDIATRIC CLINICS
Active
Other names
Lifesteps Pediatric Therapy Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOE PAUL GALLO RNC, WHNP B-C, CST (ADMINISRATOR)
(940) 367-3501
Entity
Organization
Contact information
Practice address
3501 SHEPPARD ACCESS RD, WICHITA FALLS, TX 76306-4235
(940) 851-7837
Mailing address
3501 SHEPPARD ACCESS RD, WICHITA FALLS, TX 76306-4235
(940) 851-7837
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
666670000
TX
261QR0400X
Rehabilitation Clinic/Center
Primary
666670000
TX
Other
Enumeration date
09/17/2009
Last updated
09/17/2009
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