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General NPI Number Information
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NPI Number | 1356026231
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Entity Type | Organization
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Legal Business Name | ESSENTIAL PHYSICAL THERAPY AND PERFORMANCE LLC
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 949 N HIGHWAY 67 STE 349
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City | CEDAR HILL
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State | TX
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Zip | 75104-1881
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Country | US
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Telephone | 469-319-9990
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Fax |
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Provider Business Mailing Address
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Address Line | 3656 WALNUT RIDGE DR
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City | MIDLOTHIAN
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State | TX
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Zip | 76065-7196
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | JONATHAN DAILEY
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Credential | DPT
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Telephone | 214-399-6001
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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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