Healthcare Provider Details

I. General information

NPI: 1982936688
Provider Name (Legal Business Name): BRAZOS VALLEY PHYSICAL THERAPY LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2010
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 SW 1ST ST
MINERAL WELLS TX
76067-5117
US

IV. Provider business mailing address

711 SW 1ST ST
MINERAL WELLS TX
76067-5117
US

V. Phone/Fax

Practice location:
  • Phone: 940-328-1187
  • Fax: 940-328-0579
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER D CORRIGAN
Title or Position: VP, AUTHORIZED OFFICIAL
Credential:
Phone: 713-297-7000