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General NPI Number Information
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NPI Number | 1881125821
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Entity Type | Organization
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Legal Business Name | LEGACY THERAPY SOLUTIONS
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Dates
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Enumeration Date | 03/22/2017
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Last Update Date | 07/11/2022
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Provider Practice Location Address
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Address Line | 2024 TOPAZ DR
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City | CARROLLTON
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State | TX
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Zip | 75010-4511
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Country | US
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Telephone | 214-493-1868
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Fax | 469-574-7914
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Provider Business Mailing Address
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Address Line | PO BOX 116640
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City | CARROLLTON
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State | TX
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Zip | 75011-6640
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JASON HAMMOCK
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Credential |
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Telephone | 214-493-1868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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