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General NPI Number Information
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NPI Number | 1164604575
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Entity Type | Organization
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Legal Business Name | BOERNE PHYSICAL THERAPY INSTITUTE
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Dates
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Enumeration Date | 11/28/2007
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 430 W BANDERA RD #9
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City | BOERNE
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State | TX
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Zip | 78006-2500
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Country | US
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Telephone | 830-249-7211
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Fax | 830-249-4698
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Provider Business Mailing Address
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Address Line | 430 W BANDERA RD #9
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City | BOERNE
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State | TX
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Zip | 78006-2500
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Country | US
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Telephone | 830-249-7211
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Fax | 830-249-4698
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | MR. DANIEL ERNEST KASPROWICZ JR.
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Credential | P.T., A.T.C.
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Telephone | 830-249-7211
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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 | 163071
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License Number State | TX
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