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General NPI Number Information
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NPI Number | 1346957404
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Entity Type | Organization
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Legal Business Name | ON THE MEND LLC
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Dates
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Enumeration Date | 10/28/2022
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Last Update Date | 10/28/2022
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Provider Practice Location Address
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Address Line | 575 N VALLEY PKWY STE 100
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City | LEWISVILLE
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State | TX
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Zip | 75067-3104
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Country | US
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Telephone | 972-525-9227
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Fax |
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Provider Business Mailing Address
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Address Line | 328 CINDY ST S
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City | KELLER
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State | TX
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Zip | 76248-2342
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Country | US
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Telephone | 469-986-7620
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Fax | 972-275-9921
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Authorized Official
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Title or Position | PHYSICAL THERAPIST, FOUNDER
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Name | DR. RYAN EDWARD VICK
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Credential | PT, DPT
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Telephone | 469-986-7620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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