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General NPI Number Information
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NPI Number | 1982420659
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Entity Type | Organization
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Legal Business Name | HOMETOWN PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 11/27/2024
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 712 N SECOND ST STE A
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City | HICO
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State | TX
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Zip | 76457-6217
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Country | US
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Telephone | 254-796-2150
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Fax |
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Provider Business Mailing Address
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Address Line | 2269 SENATOR ROBERT J GLASGOW LOOP
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City | STEPHENVILLE
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State | TX
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Zip | 76401-1701
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Country | US
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Telephone | 254-965-2040
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Fax | 254-796-2150
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT MARK BLACKBURN
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Credential |
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Telephone | 254-965-2040
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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 |
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License Number State |
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