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NPI Code Detail

MEDICARE: CONNECTED 2 THERAPY, PLLC

MEDICARE: CONNECTED 2 THERAPY, 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
1261QP2000XPhysical Therapy Clinic/Center672130000TX

General Provider Information

NPI Number : 1366708562
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONNECTED 2 THERAPY, PLLC
Provider Business Mailing Address
First Line : 1100 BRIDGEWOOD DR STE 102
Second Line :
City : FORT WORTH
State : TX
Zip : 76112-0808
Country : US
Telephone Number : 855-339-6978
Fax Number : 855-329-6978
Provider Business Practice Location Address
First Line : 1100 BRIDGEWOOD DR STE 102
Second Line :
City : FORT WORTH
State : TX
Zip : 76112-0808
Country : US
Telephone Number : 855-339-6978
Fax Number : 855-329-6978
Authorized Official
Title or Position : PHYSICAL THERAPIST/OWNER
Name : MS. LANDRIE MICHELE JOHANSEN
Credential : PT, MPT
Telephone Number : 855-339-6978
Provider Enumeration Date : 04/02/2012
Last Update Date : 07/30/2025

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Directions to “CONNECTED 2 THERAPY, PLLC ” Practice Location

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