Organization
ELATA HEALTH AND WELLNESS, LLC
Active
Organization
ELATA HEALTH AND WELLNESS, LLC
Active
Other names
Active Life Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA CATHERINE YAZON CUSTODIO PT (PT/OWNER)
(972) 984-7670
Entity
Organization
Contact information
Practice address
2600 ELDORADO PKWY STE 130, MCKINNEY, TX 75070-7517
(972) 984-7670
(972) 984-7671
Mailing address
2600 ELDORADO PKWY STE 130, MCKINNEY, TX 75070-7517
(972) 984-7670
(972) 984-7671
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
04/09/2016
Last updated
10/14/2022
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