Organization
PARADISE THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA CLARK (EXECUTIVE DIRECTOR)
(903) 736-5796
Entity
Organization
Contact information
Practice address
773 LYLES RD, GILMER, TX 75644-5696
(903) 736-5796
Mailing address
773 LYLES RD, GILMER, TX 75644-5696
(903) 736-5796
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
209626
TX
Other
Enumeration date
07/23/2016
Last updated
07/23/2016
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