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General NPI Number Information
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NPI Number | 1982024618
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Entity Type | Individual
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Provider Name | JOANNA LITTLER PT
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Gender | Female
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Dates
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Enumeration Date | 04/21/2014
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Last Update Date | 04/21/2014
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Provider Practice Location Address
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Address Line | 3525 FURLONG WAY
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City | FORT WORTH
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State | TX
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Zip | 76244-5103
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Country | US
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Telephone | 817-975-4696
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Fax |
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Provider Business Mailing Address
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Address Line | 12650 N BEACH ST SUITE 114, #52
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City | FORT WORTH
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State | TX
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Zip | 76244-4243
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 1180310
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License Number State | TX
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