Individual
JESSICA COLLUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2501 MUSEUM WAY, FORT WORTH, TX 76107-3058
(817) 349-7140
Mailing address
1208 USHER ST, BENBROOK, TX 76126-3514
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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