Organization
DALLAS FEDERAL PHYSICAL THERAPY AND REHABILITATION LLC
Active
Organization
DALLAS FEDERAL PHYSICAL THERAPY AND REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES WILLIS II MD (PHYSICIAN)
(469) 965-4505
Entity
Organization
Contact information
Practice address
8204 ELMBROOK DR STE 175, DALLAS, TX 75247-7212
(469) 965-4505
Mailing address
PO BOX 1347, ADDISON, TX 75001-1347
(866) 400-0476
(972) 991-9548
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/29/2020
Last updated
02/03/2020
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