Organization
ICONIC WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRUM KHAN PT, DPT (CO-OWNER, PHYSICAL THERAPIST)
(954) 993-4468
Entity
Organization
Contact information
Practice address
1806 ANDOVER DR, GARLAND, TX 75041-4147
(954) 993-4468
Mailing address
1806 ANDOVER DR, GARLAND, TX 75041-4147
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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