Individual
BEVERLY WOLLITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
124 THOMPSON CIR, LORENA, TX 76655-9682
(254) 315-8379
Mailing address
124 THOMPSON CIR, LORENA, TX 76655-9682
(254) 315-8379
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2049848
TX
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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