| Spine Works Therapy-southlake, P.l.l.c. | |
|
1001 W Southlake Blvd Southlake TX 76092-6010 | |
| (817) 310-0421 | |
| (817) 310-5870 |
| Full Name | Spine Works Therapy-southlake, P.l.l.c. |
|---|---|
| Speciality | Clinic/center |
| Location | 1001 W Southlake Blvd, Southlake, Texas |
| Authorized Official Name and Position | Jeffery B Phelps (PRESIDENT) |
| Authorized Official Contact | 8176160700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spine Works Therapy-southlake, P.l.l.c. 1001 West Southlake Blvd. Southlake TX 76092 Ph: (817) 310-0421 | Spine Works Therapy-southlake, P.l.l.c. 1001 W Southlake Blvd Southlake TX 76092-6010 Ph: (817) 310-0421 |
| NPI Number | 1619261757 |
|---|---|
| Provider Enumeration Date | 06/07/2011 |
| Last Update Date | 06/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619261757 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | L5053 (Texas) | Primary |
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