Organization
ACTION KIDS REHABILITATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT TICE LPT (PRESIDENT/CEO)
(956) 428-8951
Entity
Organization
Contact information
Practice address
5901 MCPHERSON RD, SUITE 9-B, LAREDO, TX 78041-6173
(956) 753-5437
(956) 726-4465
Mailing address
PO BOX 532047, HARLINGEN, TX 78553-2047
(956) 428-8951
(956) 428-0232
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/02/2007
Last updated
11/02/2007
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