MEDICARE: HULEN SPORTS PHYSICAL THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center	1118321	TX

General Provider Information

NPI Number	:	1528240645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HULEN SPORTS PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	3017 JOYCE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-4013
Country	:	US
Telephone Number	:	817-263-9222
Fax Number	:	817-838-1670

Provider Business Practice Location Address
First Line	:	3017 JOYCE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-4013
Country	:	US
Telephone Number	:	817-263-9222
Fax Number	:	817-838-1670

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MR. CHRIS S HOHMANN
Credential	:	MPT
Telephone Number	:	817-263-9222

Provider Enumeration Date	:	11/30/2007
Last Update Date	:	08/31/2010

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Directions to “HULEN SPORTS PHYSICAL THERAPY ” Practice Location

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