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NPI 1679684963

NPI 1679684963 : PENINSULA PHYSICAL THERAPY LIMITED PARTNERSHIP : ROCKPORT, TX

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General NPI Number Information
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    NPI Number           |    1679684963
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    Entity Type          |    Organization 
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    Legal Business Name  |    PENINSULA PHYSICAL THERAPY LIMITED PARTNERSHIP 
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Dates
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    Enumeration Date     |    08/31/2006
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    Last Update Date     |    01/20/2009
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Provider Practice Location Address
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    Address Line         |    2207 HIGHWAY 35 N SUITE A
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    City                 |    ROCKPORT
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    State                |    TX
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    Zip                  |    78382-3337
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    Country              |    US
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    Telephone            |    361-727-1925
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    Fax                  |    361-727-9257
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Provider Business Mailing Address
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    Address Line         |    1300 W SAM HOUSTON PKWY S SUITE 300
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77042-2447
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    Country              |    US
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    Telephone            |    713-297-7000
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    Fax                  |    713-297-7090
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Authorized Official
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    Title or Position    |    VP, AUTHORIZED OFFICIAL
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    Name                 |     JANNA P. KING 
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    Credential           |    JD
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    Telephone            |    713-297-7000
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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       |    
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    License Number State |    
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Taxonomy #2
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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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