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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