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NPI Code Detail

MEDICARE: CREEL PHYSICAL THERAPY

MEDICARE: CREEL PHYSICAL THERAPY
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/Center

General Provider Information

NPI Number : 1972267888
Entity Type Code : Organization
Provider Name (Legal Business Name) : CREEL PHYSICAL THERAPY
Provider Business Mailing Address
First Line : PO BOX 632351
Second Line :
City : NACOGDOCHES
State : TX
Zip : 75963-2351
Country : US
Telephone Number : 936-305-3354
Fax Number : 936-305-3990
Provider Business Practice Location Address
First Line : 4635 NE STALLINGS DR STE 104
Second Line :
City : NACOGDOCHES
State : TX
Zip : 75965-1667
Country : US
Telephone Number : 936-556-0132
Fax Number :
Authorized Official
Title or Position : OWNER/PHYSICAL THERAPIST
Name : DR. AUSTIN MATTHEW CREEL
Credential : PT, DPT, CERT. DN
Telephone Number : 936-305-3354
Provider Enumeration Date : 10/26/2021
Last Update Date : 12/09/2022

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Directions to “CREEL PHYSICAL THERAPY ” Practice Location

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