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General NPI Number Information
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NPI Number | 1730242793
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Entity Type | Organization
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Legal Business Name | CORNERSTONE PHYSICAL MEDICINE & REHABILITATION, PC
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4010 82ND ST SUITE 130
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City | LUBBOCK
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State | TX
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Zip | 79423-1949
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Country | US
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Telephone | 806-783-8234
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Fax | 806-783-8235
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Provider Business Mailing Address
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Address Line | 5907 84TH ST
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City | LUBBOCK
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State | TX
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Zip | 79424-3609
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Country | US
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Telephone | 806-783-8234
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Fax | 806-783-8235
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM THREADGILL
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Credential | PHYSICAL THERAPIST
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Telephone | 806-783-8234
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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 | TX
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