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General NPI Number Information
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NPI Number | 1871716001
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Entity Type | Organization
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Legal Business Name | GARNER & RILEY PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 623 HIGHWAY 71 W STE 100
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City | BASTROP
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State | TX
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Zip | 78602
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Country | US
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Telephone | 512-321-9659
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Fax | 512-321-1226
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Provider Business Mailing Address
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Address Line | 623 HIGHWAY 71 W STE 100
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City | BASTROP
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State | TX
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Zip | 78602-4166
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Country | US
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Telephone | 512-321-9659
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Fax | 512-321-1226
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. CONNIE S WALLACE
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Credential |
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Telephone | 512-321-9659
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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 | 643460000
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License Number State | TX
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