MEDICARE: THERAPY EXCHANGE

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	320700000X	Physical Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1659631679
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPY EXCHANGE

Provider Business Mailing Address
First Line	:	344 BRAEWICK DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76131-4274
Country	:	US
Telephone Number	:	972-786-6839
Fax Number	:	817-750-1277

Provider Business Practice Location Address
First Line	:	2240 HORSEBACK TRL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-7574
Country	:	US
Telephone Number	:	972-786-6839
Fax Number	:	817-750-1277

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. TRACEE D SMITH
Credential	:	MPT,DPT
Telephone Number	:	972-786-6839

Provider Enumeration Date	:	05/23/2012
Last Update Date	:	05/23/2012

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Directions to “THERAPY EXCHANGE ” Practice Location

Language	Start Address	Practice Location

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