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General NPI Number Information
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NPI Number | 1396568754
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Entity Type | Organization
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Legal Business Name | PHYSIOKIDS, LLC
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 5001 BYERS AVE
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City | FORT WORTH
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State | TX
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Zip | 76107-3625
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Country | US
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Telephone | 817-221-8094
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Fax |
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Provider Business Mailing Address
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Address Line | 5001 BYERS AVE
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City | FORT WORTH
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State | TX
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Zip | 76107-3625
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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 | DR. EMILY DALTON
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Credential | PT, DPT
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Telephone | 505-850-0356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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