Doctor Name: | JENNIFER MIETUS |
NPI Number: | 1679560726 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. |
License Number: | 1137222 |
Business Practice Address: | 2301 Ira E Woods Ave Building B Grapevine, TX - 760513926 |
Business Phone Number: | 8173103737 |
Business Fax Number: | 8173103736 |
Mailing Address: | 910 Hills Creek Dr, MCKINNEY |
State: | TX |
Postal Code: | 750705232 |
Phone Number: | 9724863115 |
Fax Number: | 9724863115 |
NPI Enumeration Date: | 10/04/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1137222 |
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 |