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General NPI Number Information
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NPI Number | 1194884965
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Entity Type | Organization
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Legal Business Name | THERAPY 180
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12770 CIMARRON PATH STE 132
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City | SAN ANTONIO
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State | TX
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Zip | 78249-3416
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Country | US
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Telephone | 210-561-5777
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Fax | 210-561-5770
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Provider Business Mailing Address
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Address Line | 12770 CIMARRON PATH STE 132
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City | SAN ANTONIO
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State | TX
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Zip | 78249-3416
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Country | US
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Telephone | 210-561-5777
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Fax | 210-561-5770
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Authorized Official
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Title or Position | PARTNER
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Name | MR. CHARLES RAY HUNTER SR.
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Credential | OTR
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Telephone | 210-394-0649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 108049
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License Number State | TX
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