Individual
MIRANDA L FAWCETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1301 E HOUSTON ST, BEEVILLE, TX 78102-5309
(361) 362-1700
(361) 362-1369
Mailing address
1301 E HOUSTON ST, BEEVILLE, TX 78102-5309
(361) 362-1700
(361) 362-1369
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2062937
TX
Other
Enumeration date
02/09/2012
Last updated
02/09/2012
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