Individual
MS. CHELLISA PAULINE MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1318 MEMORIAL DR, BRYAN, TX 77802-5215
(979) 776-2872
(979) 776-1456
Mailing address
1318 MEMORIAL DR, BRYAN, TX 77802-5215
(979) 776-2872
(979) 776-1456
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1179563
TX
Other
Enumeration date
03/16/2010
Last updated
04/11/2013
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