Individual
MAJESTIC ONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8207 CANOGA AVE # G3, AUSTIN, TX 78724-5728
(512) 766-6301
Mailing address
8207 CANOGA AVE # G3, AUSTIN, TX 78724-5728
(512) 766-6301
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
120323
TX
Other
Enumeration date
11/22/2015
Last updated
11/22/2015
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