Organization
ACTIVE BODY ACTIVE LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TULSI N DESAI MPT (CEO)
(734) 730-4715
Entity
Organization
Contact information
Practice address
600 S DENTON TAP RD STE 134, COPPELL, TX 75019-4551
(214) 210-0715
Mailing address
653 CANTERBURY CT, COPPELL, TX 75019-2501
(734) 730-4715
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
02/25/2019
Last updated
02/25/2019
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