Organization
PATHWAY REHABILITATION LLC
Active
Organization
PATHWAY REHABILITATION LLC
Active
Other names
Tolar Sports Therapy, Brock Sports Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX GARRETT PTA (OWNER)
(254) 485-1482
Entity
Organization
Contact information
Practice address
1140 FM 1189 STE 115, MILLSAP, TX 76066-3540
(254) 485-1482
Mailing address
582 S SUGARTREE DR, LIPAN, TX 76462-4341
(254) 485-1482
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01
01
—
Enumeration date
01/06/2022
Last updated
10/04/2022
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