Tan Ta

NPI #1003678673 in Mansfield, Texas

Provider Information

NPI Number: 1003678673
Entity Type: Individual
Name: Tan Ta
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Jan 29, 2024
Last Updated: Jan 29, 2024

Practice Location

Address: 3020 E BROAD ST STE 112
City: Mansfield
State: Texas
ZIP Code: 76063-6696
Phone: (682) 422-7580

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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