MEDICARE: FYZIO GROUP LLC

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1609595883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FYZIO GROUP LLC

Provider Business Mailing Address
First Line	:	1400 N COIT RD STE 605
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-6658
Country	:	US
Telephone Number	:	708-369-0106
Fax Number	:	214-257-0242

Provider Business Practice Location Address
First Line	:	1400 N COIT RD STE 605
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-6658
Country	:	US
Telephone Number	:	214-257-8740
Fax Number	:	214-257-0242

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	JASON GRUTZIUS
Credential	:
Telephone Number	:	708-369-0106

Provider Enumeration Date	:	08/23/2022
Last Update Date	:	08/23/2022

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Directions to “FYZIO GROUP LLC ” Practice Location

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