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Organization
PEDIATRIC AND SPORTS PHYSICAL THERAPY PLLC
Active
Organization
PEDIATRIC AND SPORTS PHYSICAL THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA JAYNE KOENIG PT, DPT (OWNER)
(972) 429-2187
Entity
Organization
Contact information
Practice address
211 REGENCY DR, SUITE 200, WYLIE, TX 75098
(972) 429-2187
(727) 429-2252
Mailing address
211 REGENCY DR, SUITE 200, WYLIE, TX 75098
(972) 429-2187
(727) 429-2252
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1219370
TX
Other
Enumeration date
02/22/2013
Last updated
02/22/2013
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