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Organization
MNM LONESTAR REHABILITATION, INC.
Active
Organization
MNM LONESTAR REHABILITATION, INC.
Active
Other names
LoneStar Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW NIEMIERA PT, CERT. MDT (PRESIDENT)
(940) 595-0566
Entity
Organization
Contact information
Practice address
915 AVENUE C, DENTON, TX 76201-6545
(940) 595-0566
Mailing address
PO BOX 634, JUSTIN, TX 76247-0634
(940) 595-0566
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001NF
BCBS
TX
05
—
179288901
—
TX
Enumeration date
06/18/2006
Last updated
12/15/2014
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