Organization
BANGS PHYSICAL THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA QUINTANILLA (CLINIC ADMINISTRATOR)
(325) 752-6819
Entity
Organization
Contact information
Practice address
807 E HALL ST, BANGS, TX 76823-5400
(325) 752-6819
Mailing address
807 E HALL ST, BANGS, TX 76823-5400
(325) 752-6819
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1176377
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0088QA
BCBS
—
Enumeration date
10/23/2007
Last updated
05/16/2008
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