Healthcare Provider Details

I. General information

NPI: 1932441466
Provider Name (Legal Business Name): VALERIE ANN MUTTER P.T., MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2013
Last Update Date: 03/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2519 S LAKELINE BLVD STE 100
CEDAR PARK TX
78613-2964
US

IV. Provider business mailing address

12309 CAPELLA TRL
AUSTIN TX
78732-1940
US

V. Phone/Fax

Practice location:
  • Phone: 512-331-6200
  • Fax: 512-331-6384
Mailing address:
  • Phone: 512-266-3387
  • Fax: 512-266-3387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1162159
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: