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General NPI Number Information
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NPI Number | 1669706081
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Entity Type | Organization
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Legal Business Name | PRIMARY THERAPY SPECIALISTS LLC
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Dates
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Enumeration Date | 10/01/2009
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Last Update Date | 10/01/2009
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Provider Practice Location Address
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Address Line | 3031 W ALBERTA RD
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City | EDINBURG
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State | TX
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Zip | 78539-3118
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Country | US
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Telephone | 956-330-5317
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Fax |
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Provider Business Mailing Address
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Address Line | 1027 S 12TH AVE
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City | EDINBURG
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State | TX
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Zip | 78539-5605
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Country | US
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Telephone | 956-330-5317
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MRS. JOCELYN R MCDONALD
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Credential | P.T.
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Telephone | 956-330-5317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1-8926-6
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License Number State | TX
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