MEDICARE: UPLIFT PHYSICAL THERAPY AND PERFORMANCE, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1144957739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPLIFT PHYSICAL THERAPY AND PERFORMANCE, PLLC

Provider Business Mailing Address
First Line	:	7523 ROBIN REST DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-3135
Country	:	US
Telephone Number	:	253-722-4065
Fax Number	:

Provider Business Practice Location Address
First Line	:	7523 ROBIN REST DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-3135
Country	:	US
Telephone Number	:	253-722-4065
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMANDA FRANK
Credential	:	PT
Telephone Number	:	253-722-4065

Provider Enumeration Date	:	08/03/2022
Last Update Date	:	08/03/2022

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