Individual
AUDREY HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6080 SOUTHWEST BLVD, BENBROOK, TX 76109-3912
(817) 731-9331
(817) 731-9882
Mailing address
6080 SOUTHWEST BLVD, BENBROOK, TX 76109-3912
(817) 731-9331
(817) 731-9882
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2112802
TX
Other
Enumeration date
08/11/2015
Last updated
08/11/2015
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