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General NPI Number Information
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NPI Number | 1457157257
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Entity Type | Organization
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Legal Business Name | AT HOME PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 223 MAGNOLIA WAY
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City | LEAGUE CITY
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State | TX
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Zip | 77573-4640
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Country | US
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Telephone | 281-409-3915
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Fax |
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Provider Business Mailing Address
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Address Line | 223 MAGNOLIA WAY
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City | LEAGUE CITY
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State | TX
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Zip | 77573-4640
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Country | US
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Telephone | 281-409-3915
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Fax |
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Authorized Official
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Title or Position | OWNER, PROVIDER, AUTHORIZED OFFICIA
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Name | BRYCE JEFFREY
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Credential | P.T.
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Telephone | 281-409-3915
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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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