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Individual

BRENDA JO PLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
700 E VISTA RIDGE MALL DR, LEWISVILLE, TX 75067-8339
(972) 906-9789
Mailing address
823 CARRIE CT, LAKEWOOD VILLAGE, TX 75068-4396
(817) 239-2360

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2035400
TX

Other

Enumeration date
09/05/2018
Last updated
09/05/2018
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