Organization
ROCKPORT THERAPY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINCOLN WAYNE DAVIS PTA (REGISTERED AGENT)
(361) 727-6141
Entity
Organization
Contact information
Practice address
1004 E MAIN ST STE D, ROCKPORT, TX 78382-2610
(361) 389-8253
Mailing address
1004 E MAIN ST STE D, ROCKPORT, TX 78382-2610
(361) 389-8253
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
12/07/2017
Last updated
01/31/2018
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