Individual
STEPHANIE RENEE NYBORG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5515 GLEN LAKES DR, DALLAS, TX 75231-4309
(214) 361-8923
Mailing address
205 BENTON DR APT 7302, ALLEN, TX 75013-8589
(972) 678-0280
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2058380
TX
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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