Doctor Name: | MICAH GORENA |
NPI Number: | 1265893218 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | 1271375 |
Business Practice Address: | 1313 N Belt Line Rd Suite 102 Mesquite, TX - 751491783 |
Business Phone Number: | 9722890691 |
Business Fax Number: | |
Mailing Address: | 1313 N Belt Line Rd, Suite 102 MESQUITE |
State: | TX |
Postal Code: | 751491783 |
Phone Number: | 9722890691 |
Fax Number: | |
NPI Enumeration Date: | 03/17/2016 |
NPI Last Update Date: | 03/17/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1271375 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |