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General NPI Number Information
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NPI Number | 1972267888
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Entity Type | Organization
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Legal Business Name | CREEL PHYSICAL THERAPY
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Dates
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Enumeration Date | 10/26/2021
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Last Update Date | 12/09/2022
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Provider Practice Location Address
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Address Line | 4635 NE STALLINGS DR STE 104
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City | NACOGDOCHES
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State | TX
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Zip | 75965-1667
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Country | US
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Telephone | 936-556-0132
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 632351
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City | NACOGDOCHES
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State | TX
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Zip | 75963-2351
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Country | US
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Telephone | 936-305-3354
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Fax | 936-305-3990
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DR. AUSTIN MATTHEW CREEL
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Credential | PT, DPT, CERT. DN
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Telephone | 936-305-3354
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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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