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General NPI Number Information
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NPI Number | 1588199723
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Entity Type | Organization
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Legal Business Name | CORESSENTIALS PHYSICAL THERAPY AND PELVIC WELLNESS
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Dates
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Enumeration Date | 04/25/2017
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Last Update Date | 04/25/2017
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Provider Practice Location Address
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Address Line | 20330 HUEBNER RD STE 102
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3509
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Country | US
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Telephone | 210-725-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 20330 HUEBNER RD STE 102
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3509
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Country | US
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Telephone | 210-725-3700
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | JENNIFER DANIELLE DUGGINS
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Credential | PT
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Telephone | 210-725-3700
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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 | 1092559
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License Number State | TX
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