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General NPI Number Information
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NPI Number | 1376534107
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Entity Type | Individual
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Provider Name | NICOLE HEATHER RANEY PT, DSC, FAAOMPT
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Gender | Female
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Dates
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Enumeration Date | 11/01/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | WILFORD HALL MEDICAL CENTER 2200 BERQUIST DR, PHYSICAL THERAPY CLINIC
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City | LACKLAND AFB
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State | TX
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Zip | 78236
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Country | US
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Telephone | 210-292-5023
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Fax | 210-292-7991
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Provider Business Mailing Address
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Address Line | 134 EVANS AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78209-3720
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Country | US
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Telephone | 210-667-6192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1148297
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License Number State | TX
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