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General NPI Number Information
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NPI Number | 1568573301
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Entity Type | Organization
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Legal Business Name | WELLNESS AND THERAPY SOLUTIONS
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 610 N 8TH ST SUITE 6
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City | GUNTER
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State | TX
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Zip | 75058-3586
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Country | US
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Telephone | 903-433-1401
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Fax | 903-433-1398
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Provider Business Mailing Address
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Address Line | PO BOX 247
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City | GUNTER
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State | TX
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Zip | 75058-0247
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Country | US
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Telephone | 903-433-1401
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Fax | 903-433-1398
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Authorized Official
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Title or Position | SECRETARY
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Name | SAMUEL MARLIN GIBSON
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Credential | P.T.
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Telephone | 903-433-1401
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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 | 1132587
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License Number State | TX
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