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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