Individual
MARISA LONGORIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 S BRYAN RD, MISSION, TX 78572-6840
(855) 687-8282
Mailing address
413 BUSINESS CENTER DR, PALMVIEW, TX 78572-6289
(956) 360-0504
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2084249
TX
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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