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Organization
SPACE CITY PHYSICAL THERAPY LLC
Active
Organization
SPACE CITY PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEWIS K. CLARKE MD (PRESIDENT)
(281) 316-7160
Entity
Organization
Contact information
Practice address
17448 HIGHWAY 3, SUITE 130, WEBSTER, TX 77598-4197
(281) 316-7160
(281) 316-7165
Mailing address
17448 HIGHWAY 3, #130, P. O. BOX 58086, WEBSTER, TX 77598-8086
(281) 316-7160
(281) 316-7165
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
02/04/2010
Last updated
02/04/2010
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