Individual
IVAN BARBOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5931 REIGER AVE, DALLAS, TX 75214
(915) 491-1275
Mailing address
5931 REIGER AVE, DALLAS, TX 75214
(915) 491-1275
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2082271
TX
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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