| Kody Wallace, | |
|
400 Sw 25th Ave, Mineral Wells, TX 76067-8246 | |
| (940) 328-6580 | |
| (940) 328-6550 |
| Full Name | Kody Wallace |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 400 Sw 25th Ave, Mineral Wells, Texas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912061607 | NPI | - | NPPES |
| 1141471 | Other | TX | PT LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 1141471 (Texas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Kody Wallace, 705 N Murco Dr, Mineral Wells, TX 76067-9008 Ph: () - | Kody Wallace, 400 Sw 25th Ave, Mineral Wells, TX 76067-8246 Ph: (940) 328-6580 |
Mrs. Gwendolyn Moore Jones, LPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 711 Sw 1st St, Mineral Wells, TX 76067 Phone: 940-328-1187 Fax: 940-328-0579 | |
Elizabeth Olive Cameron, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 100 E Hubbard St Ste 101, Mineral Wells, TX 76067 Phone: 940-412-9200 Fax: 817-594-9202 | |
Loyd Lendon Lauglaug Abastas, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 711 Sw 1st St, Mineral Wells, TX 76067 Phone: 940-328-1187 Fax: 940-328-0579 | |
Amy Bridges Eswein, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 711 Sw 1st St, Mineral Wells, TX 76067 Phone: 940-328-1187 Fax: 940-328-0579 | |
Brandon Wade Hons, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 320 Sw 25th Ave, Mineral Wells, TX 76067 Phone: 940-328-6580 | |
Chontell Denise Holdman, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2801 Highway 180 E, Mineral Wells, TX 76067 Phone: 817-569-5700 Fax: 773-233-9607 | |
Mr. Michael Joseph Gremminger, LPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 711 Sw 1st St, Mineral Wells, TX 76067 Phone: 940-328-1187 Fax: 940-328-0579 |