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General NPI Number Information
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NPI Number | 1811104086
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Entity Type | Organization
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Legal Business Name | RICHARDSON SPINE AND SPORTS THERAPY CENTER LLC
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/17/2017
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Provider Practice Location Address
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Address Line | 375 MUNICIPAL DR SUITE 108
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City | RICHARDSON
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State | TX
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Zip | 75080-3559
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Country | US
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Telephone | 214-575-4040
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Fax | 214-575-4041
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Provider Business Mailing Address
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Address Line | 375 MUNICIPAL DR SUITE 108
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City | RICHARDSON
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State | TX
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Zip | 75080-3559
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Country | US
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Telephone | 214-575-4040
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Fax | 214-575-4041
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Authorized Official
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Title or Position | OWNER
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Name | MR. CURTIS J GOODWIN
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Credential | PT
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Telephone | 214-575-4040
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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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