Organization
SOFIA WILTENS LPT
Active
Other names
VERSATILE PHYSICAL THERAPY AND FITNESS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SOFIA S. WILTENS SR. LPT (DIRECTOR/LPT)
(512) 707-8392
Entity
Organization
Contact information
Practice address
1221 W BEN WHITE BLVD, 211A, AUSTIN, TX 78704-6888
(512) 707-8392
(512) 707-2841
Mailing address
1221 W BEN WHITE BLVD, 211A, AUSTIN, TX 78704-6888
(512) 707-8392
(512) 707-2841
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1062495
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009JZ
BCBS GROUP NUMBER
TX
Enumeration date
04/10/2007
Last updated
08/19/2008
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