Organization
CARTHAGE PHYSICAL THERAPY, PLLC
Active
Organization
CARTHAGE PHYSICAL THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAYTON H. BRAKEVILLE M.S.P.T. (PHYSICAL THERAPIST/OWNER)
(903) 694-9371
Entity
Organization
Contact information
Practice address
107 S. DANIELS ST, CARTHAGE, TX 75633
(903) 694-9371
(903) 694-2898
Mailing address
107 S. DANIELS ST, CARTHAGE, TX 75633
(903) 694-9371
(903) 694-2898
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0071DL
BLUE CROSS GROUP #
TX
Enumeration date
10/03/2006
Last updated
08/22/2020
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