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Organization
LAGO VISTA PHYSICAL THERAPY
Active
Organization
LAGO VISTA PHYSICAL THERAPY
Active
Other names
Leander Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY LEIGH COLDICOTT MSPT (OWNER)
(512) 267-5400
Entity
Organization
Contact information
Practice address
5802 THUNDERBIRD ST., SUITE A, LAGO VISTA, TX 78645
(512) 267-5400
(512) 267-5700
Mailing address
PO BOX 4649, LAGO VISTA, TX 78645
(512) 267-5400
(512) 267-5700
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1182499
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201463102
—
TX
Enumeration date
11/05/2009
Last updated
11/05/2009
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