Organization
FUNCTIONAL STABILITY & MOBILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN ELIZABETH HUTCHINSON FRAZIER OTR (OWNER)
(609) 354-8883
Entity
Organization
Contact information
Practice address
2112 MILES ST, COPPERAS COVE, TX 76522-4144
(254) 290-3333
(254) 300-9246
Mailing address
2112 MILES ST, COPPERAS COVE, TX 76522-4144
(254) 290-3333
(254) 300-9246
Taxonomy
Speciality
Code
Description
License number
State
225XR0403X
Driving and Community Mobility Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
803010081
CERTIFICATE OF FILING NUMBER
TX
Enumeration date
08/20/2020
Last updated
09/11/2020
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