Individual
LISA RIVAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
404 RACQUET CLUB BLVD, BEDFORD, TX 76022
(682) 738-3056
Mailing address
315 MARTHA LN, FORT WORTH, TX 76126
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2119760
TX
Other
Enumeration date
09/01/2017
Last updated
09/01/2017
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