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General NPI Number Information
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NPI Number | 1669244034
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Entity Type | Organization
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Legal Business Name | JACKIE WEST PHYSICAL THERAPY
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Dates
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Enumeration Date | 10/27/2023
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 6618 SITIO DEL RIO BLVD STE D103
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City | AUSTIN
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State | TX
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Zip | 78730-1148
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Country | US
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Telephone | 512-222-7787
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Fax | 512-566-3042
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Provider Business Mailing Address
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Address Line | 13359 N HIGHWAY 183 STE 406 PMB 2036
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City | AUSTIN
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State | TX
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Zip | 78750
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Country | US
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Telephone |
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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 | JACQUELINE C WEST
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Credential | PT, DPT, FAAOMPT
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Telephone | 512-222-7787
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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 |
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License Number State |
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