Organization
CLEARCUT ORTHO, LLC
Active
Organization
CLEARCUT ORTHO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH WHEELER DPT, OCS, NCS (OWNER/PHYSICAL THERAPIST)
(817) 719-7714
Entity
Organization
Contact information
Practice address
1001 12TH AVE STE 201, FORT WORTH, TX 76104
(817) 719-7714
(817) 796-1114
Mailing address
1001 12TH AVE STE 201, FORT WORTH, TX 76104-3926
(817) 719-7714
(817) 796-1114
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251E1300X
Clinical Electrophysiology Physical Therapist
—
—
2251N0400X
Neurology Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
394270802
—
TX
Enumeration date
07/24/2018
Last updated
09/16/2022
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