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General NPI Number Information
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NPI Number | 1891733838
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Entity Type | Organization
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Legal Business Name | THERASPECIALISTS INC
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 296 MARVIN HANCOCK DR
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City | JASPER
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State | TX
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Zip | 75951-3479
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Country | US
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Telephone | 409-384-7041
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Fax | 409-384-7064
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Provider Business Mailing Address
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Address Line | 296 MARVIN HANCOCK DR
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City | JASPER
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State | TX
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Zip | 75951-3479
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Country | US
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Telephone | 409-384-7041
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Fax | 409-384-7064
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARY G MALONE
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Credential | PT DPT
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Telephone | 409-384-7041
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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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