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Organization
FORT WORTH PHYSICAL THERAPY PLLC
Active
Organization
FORT WORTH PHYSICAL THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUZANNE WELCH (CREDENTIALS COORDINATOR)
(817) 304-4786
Entity
Organization
Contact information
Practice address
7277 HAWKINS VIEW DRIVE, FORT WORTH, TX 76132-3921
(817) 423-5611
(817) 423-5577
Mailing address
7277 HAWKINS VIEW DR, FORT WORTH, TX 76132-3921
(817) 423-5611
(817) 423-5577
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1117091
TX
225X00000X
Occupational Therapist
109622
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196088201
—
TX
Enumeration date
06/07/2007
Last updated
09/24/2009
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