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General NPI Number Information
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NPI Number | 1659631679
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Entity Type | Organization
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Legal Business Name | THERAPY EXCHANGE
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Dates
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Enumeration Date | 05/23/2012
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Last Update Date | 05/23/2012
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Provider Practice Location Address
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Address Line | 2240 HORSEBACK TRL
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City | FORT WORTH
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State | TX
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Zip | 76177-7574
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Country | US
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Telephone | 972-786-6839
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Fax | 817-750-1277
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Provider Business Mailing Address
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Address Line | 344 BRAEWICK DR
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City | FORT WORTH
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State | TX
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Zip | 76131-4274
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Country | US
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Telephone | 972-786-6839
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Fax | 817-750-1277
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. TRACEE D SMITH
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Credential | MPT,DPT
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Telephone | 972-786-6839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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