Individual
MRS. KELLI JO BRIZZOLARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, OCS
Contact information
Practice address
7115 GREENVILLE AVE, SUITE 300, DALLAS, TX 75231-5100
(214) 239-0990
(214) 239-0991
Mailing address
PO BOX 670769, DALLAS, TX 75367-0769
(214) 239-0990
(214) 239-0991
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1153751
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8T7997
BLUE CROSS BLUE SHIELD OF TEXAS
TX
Enumeration date
05/03/2007
Last updated
05/29/2008
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