Individual
MRUDUL RAJAN JAGTAP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
101 WATERMERE DR, SOUTHLAKE, TX 76092-8116
(817) 431-8668
Mailing address
9541 SINCLAIR ST, FORT WORTH, TX 76244-5971
(973) 572-3452
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
115555
TX
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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