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General NPI Number Information
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NPI Number | 1689168007
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Entity Type | Organization
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Legal Business Name | PACE PHYSICAL THERAPY
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 01/24/2019
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Provider Practice Location Address
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Address Line | 906 BRENTWOOD ST
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City | AUSTIN
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State | TX
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Zip | 78757-3033
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Country | US
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Telephone | 208-841-4894
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Fax |
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Provider Business Mailing Address
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Address Line | 7756 NORTHCROSS DR STE 100
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City | AUSTIN
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State | TX
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Zip | 78757-1736
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Country | US
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Telephone | 512-207-0368
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Fax | 737-443-6071
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | DR. JESSICA WARNECKE
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Credential | PT
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Telephone | 512-207-0368
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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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