Organization
CHAMPION PERFORMANCE PHYSICAL THERAPY, PC
Active
Organization
CHAMPION PERFORMANCE PHYSICAL THERAPY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTIE JEAN POWELL MSPT (OWNER, PHYSICAL THERAPIST)
(512) 996-0441
Entity
Organization
Contact information
Practice address
12611 HYMEADOW DR, AUSTIN, TX 78729-2700
(512) 996-0441
(512) 996-0442
Mailing address
PO BOX 170040, AUSTIN, TX 78717-0003
(512) 996-0441
(512) 996-0442
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
656610000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0045MR
BC/BS PROVIDER NUMBER
TX
01
—
3418380
CIGNA
TX
01
—
7141718
AETNA
TX
Enumeration date
03/14/2006
Last updated
07/28/2010
Update your record
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