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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
DR. LAURA KOENIG DPT (OWNER/DIRECTOR)
(972) 429-2187
Entity
Organization
Contact information
Practice address
211 REGENCY DRIVE, STE 200, WYLIE, TX 75098-7011
(972) 429-2187
(727) 429-2252
Mailing address
211 REGENCY DR, STE 200, WYLIE, TX 75098-7011
(972) 429-2187
(727) 429-2252
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1219370
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1219370
LICENSE
TX
Enumeration date
02/26/2013
Last updated
02/26/2013
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