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General NPI Number Information
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NPI Number | 1265114508
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Entity Type | Organization
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Legal Business Name | TOTAL PHYSICAL THERAPY & REHAB
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Dates
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Enumeration Date | 08/04/2023
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 301 DANCE DR
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City | WEST COLUMBIA
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State | TX
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Zip | 77486-4015
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Country | US
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Telephone | 979-665-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 9036 COUNTY ROAD 628
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City | BRAZORIA
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State | TX
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Zip | 77422-6640
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Country | US
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Telephone | 979-665-8888
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | LISA MICHELLE BRUNNER
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Credential | PT
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Telephone | 979-665-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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