Individual
MARY LEE GLORIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 E WARD ST, GOLIAD, TX 77963-4006
(361) 645-8902
Mailing address
1016 NEVADA ST, MATHIS, TX 78368-3348
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2105570
TX
Other
Enumeration date
09/11/2018
Last updated
09/11/2018
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