Organization
WATERFALLS MEDICAL CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLENDA MARITZA QUINTEROZ (PRESIDENT)
(512) 300-6213
Entity
Organization
Contact information
Practice address
111 W ANDERSON LN, SUITE D217 A, AUSTIN, TX 78752-1132
(512) 420-8195
Mailing address
111 W ANDERSON LN, SUITE D217 A, AUSTIN, TX 78752-1132
(512) 420-8195
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
6180
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6180
CHIROPRACTIC
TX
Enumeration date
11/24/2009
Last updated
11/24/2009
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