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General NPI Number Information
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NPI Number | 1841898137
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Entity Type | Organization
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Legal Business Name | PINEYWOODS PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 10/09/2020
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Last Update Date | 10/09/2020
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Provider Practice Location Address
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Address Line | 1400 WEST 6TH STREET SUITE 6 AND 7
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City | RUSK
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State | TX
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Zip | 75785
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Country | US
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Telephone | 936-645-3348
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 979
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City | RUSK
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State | TX
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Zip | 75785-0979
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Country | US
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Telephone | 936-645-3348
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAD EVANS SCOTT
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Credential | PT, DPT
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Telephone | 936-645-3348
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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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