Organization
WHITCOMB MEMORIAL PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN J WHITCOMB P.T. (OWNER/P.T. ADMINISTRATOR)
(972) 262-6974
Entity
Organization
Contact information
Practice address
2705 HOSPITAL BLVD, SUITE 100, GRAND PRAIRIE, TX 75051-1017
(972) 262-6974
(972) 264-3073
Mailing address
PO BOX 530451, GRAND PRAIRIE, TX 75053-0451
(972) 262-6974
(972) 264-3073
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0084CY
BLUE CROSS BLUE SHIELD
TX
Enumeration date
01/04/2006
Last updated
08/22/2020
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