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General NPI Number Information
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NPI Number | 1366060600
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Entity Type | Organization
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Legal Business Name | JOURNEY PT AND WELLNESS LLC
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Dates
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Enumeration Date | 07/13/2020
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Last Update Date | 07/13/2020
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Provider Practice Location Address
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Address Line | 2717 LONE STAR LN
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City | GRAPEVINE
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State | TX
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Zip | 76051-2517
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Country | US
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Telephone | 817-538-7519
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Fax |
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Provider Business Mailing Address
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Address Line | 2717 LONE STAR LN
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City | GRAPEVINE
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State | TX
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Zip | 76051-2517
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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 | MANAGING MEMBER/OWNER
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Name | PATRICIA COVEY
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Credential | PT
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Telephone | 817-538-7519
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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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