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General NPI Number Information
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NPI Number | 1679393706
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Entity Type | Organization
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Legal Business Name | PELVIC HARMONY PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 2118 ROBIN HOOD DR
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City | CANYON LAKE
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State | TX
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Zip | 78133-4981
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Country | US
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Telephone | 830-221-5158
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1293
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City | CANYON LAKE
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State | TX
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Zip | 78133-0001
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Country | US
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Telephone | 830-717-9390
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Fax |
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | BROOKE BAKER
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Credential | PT, DPT
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Telephone | 830-717-9390
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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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