Individual
JASSELLE BAGANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5909 BEVERLY DR E, 2126, BENBROOK, TX 76132-5808
(817) 903-1920
Mailing address
5909 BEVERLY DR E, 2126, BENBROOK, TX 76132-5808
(817) 903-1920
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
006745
NY
Other
Enumeration date
01/05/2011
Last updated
01/05/2011
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