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Organization
GARNER & RILEY PHYSICAL THERAPY PC
Active
Organization
GARNER & RILEY PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CONNIE S WALLACE (OFFICE MANAGER)
(512) 321-9659
Entity
Organization
Contact information
Practice address
623 HIGHWAY 71 W STE 100, BASTROP, TX 78602
(512) 321-9659
(512) 321-1226
Mailing address
623 HIGHWAY 71 W STE 100, BASTROP, TX 78602-4166
(512) 321-9659
(512) 321-1226
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
643460000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00074GR
BLUE CROSS
TX
01
—
01065831
AMERIGROUP
TX
05
—
146386101
—
TX
Enumeration date
04/10/2007
Last updated
01/23/2020
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