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General NPI Number Information
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NPI Number | 1053514430
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY OF GUN BARREL CITY, PLLC
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 11/13/2018
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Provider Practice Location Address
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Address Line | 907 S. PALESTINE
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City | ATHENS
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State | TX
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Zip | 75751
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Country | US
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Telephone | 903-675-0077
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Fax | 903-675-0078
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Provider Business Mailing Address
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Address Line | PO BOX 2028
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City | ATHENS
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State | TX
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Zip | 75751
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Country | US
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Telephone | 903-675-0077
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Fax | 903-675-0078
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Authorized Official
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Title or Position | THERAPIST IN CHARGE/CO-OWNER
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Name | MR. DON F. VALLIE
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Credential | PT
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Telephone | 903-675-0077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1019057
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License Number State | TX
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