Organization
IDEAL PHYSICAL THERAPY OF TEXAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT KIRK (DIRECTOR)
(708) 710-9931
Entity
Organization
Contact information
Practice address
12222 COIT RD STE 200, DALLAS, TX 75251-2302
(972) 979-6577
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/26/2020
Last updated
02/26/2020
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