Organization
PREMIER REHAB PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA UNDERWOOD (ADMINSTRATOR)
(817) 200-7445
Entity
Organization
Contact information
Practice address
4120 HERITAGE TRACE PKWY STE 220, KELLER, TX 76248
(817) 741-7585
Mailing address
4120 HERITAGE TRACE PKWY STE 220, KELLER, TX 76248
(817) 741-7585
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1263891
TX
Other
Enumeration date
09/10/2015
Last updated
09/10/2015
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