Organization
512 PHYSICAL THERAPY AND GOLF PERFORMANCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JEROME ODELL PT (OWNER)
(512) 699-2162
Entity
Organization
Contact information
Practice address
4425 S MOPAC EXPY STE 101, AUSTIN, TX 78735-6710
(512) 669-2162
(512) 572-3272
Mailing address
8304 ALOPHIA DR, AUSTIN, TX 78739-1999
(512) 699-2162
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
TX
Other
Enumeration date
08/22/2016
Last updated
03/03/2022
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