Organization
PRACTIVA HEALTH LLC
Active
Organization
PRACTIVA HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PIETER LAURUS DE SMIDT PT (OWNER)
(210) 949-0070
Entity
Organization
Contact information
Practice address
5282 MEDICAL DR, SUITE 205A, SAN ANTONIO, TX 78229-4849
(210) 949-0070
(210) 949-0277
Mailing address
29144 OLD FREDERICKSBURG RD, BOERNE, TX 78015-9101
(210) 949-0070
(210) 949-0277
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1072643
TX
Other
Enumeration date
08/21/2008
Last updated
08/21/2008
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