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General NPI Number Information
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NPI Number | 1104103852
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Entity Type | Organization
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Legal Business Name | FOUNDATION PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 11/09/2011
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Last Update Date | 10/12/2012
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Provider Practice Location Address
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Address Line | 23127 IH 10 WEST SUITE 203
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City | SAN ANTONIO
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State | TX
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Zip | 78257-2506
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Country | US
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Telephone | 210-698-6333
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Fax | 210-698-6332
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Provider Business Mailing Address
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Address Line | 23127 IH 10 W SUITE 203
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City | SAN ANTONIO
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State | TX
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Zip | 78257-2506
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Country | US
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Telephone | 210-698-6333
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Fax | 210-698-6332
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Authorized Official
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Title or Position | CEO/PHYSICAL THERAPIST
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Name | CHRISTIAN COMPEAN
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Credential | P.T.
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Telephone | 210-698-6333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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