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General NPI Number Information
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NPI Number | 1255809554
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Entity Type | Organization
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Legal Business Name | PHOENIX WELLNESS & REHAB LLC
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Dates
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Enumeration Date | 11/05/2018
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 6501 DALROCK RD STE 118A
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City | ROWLETT
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State | TX
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Zip | 75089-2046
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Country | US
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Telephone | 972-232-2310
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Fax | 972-232-7925
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Provider Business Mailing Address
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Address Line | 6501 DALROCK RD STE 118A
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City | ROWLETT
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State | TX
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Zip | 75089-2046
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Country | US
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Telephone | 972-232-2310
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Fax | 972-232-7925
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. RUSSELL LYLE DARRINGTON
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Credential | MS, PT
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Telephone | 972-232-2310
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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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