Individual
MR. BENITO V CORRALEZ III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4910 EMORY ST, LUBBOCK, TX 79416-3026
(806) 740-0800
Mailing address
4910 EMORY ST, LUBBOCK, TX 79416-3026
(806) 740-0800
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2104791
TX
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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