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General NPI Number Information
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NPI Number | 1124896147
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Entity Type | Individual
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Provider Name | DAVID MICHAEL ALSDORF LMT
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Gender | Male
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Dates
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Enumeration Date | 12/19/2023
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 5230 DENTON HWY # 117
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City | HALTOM CITY
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State | TX
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Zip | 76148-4100
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Country | US
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Telephone | 817-523-1525
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Fax |
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Provider Business Mailing Address
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Address Line | 3520 W HIGHWAY 199
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City | SPRINGTOWN
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State | TX
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Zip | 76082-5259
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Country | US
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Telephone | 817-523-1525
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT115116
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License Number State | TX
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