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General NPI Number Information
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NPI Number | 1467531228
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Entity Type | Organization
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Legal Business Name | PG DALEY & CR BOONE PTR CLEAR LAKE PHYSICAL THERAPY
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 520 BLOSSOM STREET
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City | WEBSTER
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State | TX
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Zip | 77598
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Country | US
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Telephone | 281-332-1569
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Fax | 281-316-2464
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Provider Business Mailing Address
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Address Line | 520 BLOSSOM ST CLEAR LAKE PHYSICAL THERAPY
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City | WEBSTER
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State | TX
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Zip | 77598
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Country | US
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Telephone | 281-332-1569
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Fax | 281-316-2464
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Authorized Official
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Title or Position | BUS. MANAGER
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Name | MS. SHERRYN L. O'TOOLE
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Credential |
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Telephone | 281-332-1569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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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 | 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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