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General NPI Number Information
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NPI Number | 1821206921
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Entity Type | Organization
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Legal Business Name | SNEAKERS REHABILITATION, INC
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2300 COIT RD STE 207
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City | PLANO
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State | TX
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Zip | 75075-3770
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Country | US
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Telephone | 214-735-3603
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Fax | 877-871-5352
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Provider Business Mailing Address
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Address Line | 4960 SHADY OAK TRL
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-4468
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Country | US
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Telephone | 214-735-3603
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Fax | 877-871-5352
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Authorized Official
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Title or Position | PT
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Name | MR. RANDALL H HARMS
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Credential | PT
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Telephone | 214-735-3603
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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 | TX
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