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General NPI Number Information
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NPI Number | 1255874871
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Entity Type | Organization
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Legal Business Name | RETROFIT PERFORMANCE TRAINING LLC
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Dates
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Enumeration Date | 11/30/2016
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Last Update Date | 11/30/2016
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Provider Practice Location Address
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Address Line | 720 AIRPORT BLVD TRLR 71
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City | AUSTIN
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State | TX
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Zip | 78702-4107
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Country | US
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Telephone | 806-674-5217
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Fax |
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Provider Business Mailing Address
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Address Line | 8123 FEWELL TRL
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City | AMARILLO
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State | TX
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Zip | 79119-5858
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Country | US
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Telephone | 817-798-3198
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Fax |
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Authorized Official
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Title or Position | OWNER - PHYSICAL THERAPIST
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Name | DR. ADAM CHRISTOPHER HUGHES
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Credential | DPT
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Telephone | 806-674-5217
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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 | 1263805
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License Number State | TX
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