Organization
SNATCHED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANNAH BURLESON (OWNER)
(214) 450-5201
Entity
Organization
Contact information
Practice address
9336 TEAM RANCH RD, 101A, FORT WORTH, TX 76126-2016
(682) 777-4572
Mailing address
9336 TEAM RANCH RD, 101A, FORT WORTH, TX 76126-2016
(682) 777-4572
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
18004653203
TX
Other
Enumeration date
08/19/2015
Last updated
08/19/2015
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