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General NPI Number Information
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NPI Number | 1699716076
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Entity Type | Organization
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Legal Business Name | FREEDOM PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5310 ACTON HWY SUITE 106
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City | GRANBURY
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State | TX
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Zip | 76049-2948
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Country | US
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Telephone | 817-326-1375
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Fax |
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Provider Business Mailing Address
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Address Line | 5310 ACTON HWY SUITE 106
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City | GRANBURY
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State | TX
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Zip | 76049-2948
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Country | US
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Telephone | 817-326-1375
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST ASST.
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Name | MR. JOHN R MCNAUGHTON
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Credential | P.T.A.
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Telephone | 817-326-1375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2042067
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License Number State | TX
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