Organization Name: | GENESIS PHYSICAL THERAPY |
NPI Number: | 1043469075 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DONALD R ZIVNEY (OWNER) |
Mailing Address: | 547 E I30 Rockwall |
State: | TX US |
Postal Code: | 750875408 |
Phone Number: | 2146790186 |
Fax Number: | |
NPI Enumeration Date: | 09/15/2008 |
NPI Last Update Date: | 09/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 1039998 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |