Individual
JOLLY DAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3365 REGENT BLVD STE 130, IRVING, TX 75063-3127
(469) 647-4833
Mailing address
11600 AUDELIA RD APT 132, DALLAS, TX 75243-4744
(980) 327-9096
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1367751
TX
Other
Enumeration date
06/29/2023
Last updated
06/29/2023
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