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General NPI Number Information
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NPI Number | 1457536609
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Entity Type | Organization
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Legal Business Name | CORE PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 07/30/2009
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Provider Practice Location Address
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Address Line | 230 PARKING WAY
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City | LAKE JACKSON
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State | TX
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Zip | 77566
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Country | US
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Telephone | 979-297-2900
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Fax | 979-297-2901
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Provider Business Mailing Address
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Address Line | PO BOX 1946
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City | ANGLETON
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State | TX
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Zip | 77516-1946
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Country | US
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Telephone | 979-297-2900
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Fax | 979-297-2901
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | MS. HELEN HAVANA FELTMAN
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Credential | PLT,CFT
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Telephone | 979-297-2900
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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 | 1055911
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License Number State | TX
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