Lake Fork Physical Therapy, Pllc

NPI #1154540540 in Emory, Texas

Provider Information

NPI Number: 1154540540
Entity Type: Organization
Organization Name: Lake Fork Physical Therapy, Pllc
Primary Specialty: Physical Therapist
Enumeration Date: Apr 24, 2007
Last Updated: Jul 8, 2014

Practice Location

Address: 903 EAST LENNON STREET
Address 2: SUITE 101
City: Emory
State: Texas
ZIP Code: 75440
Phone: (903) 474-9436

Authorized Official

Name: MR. PAUL BACON, L.P.T.
Title: LICENSED PHYSICAL THERAPIST
Phone: (903) 474-9436

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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MR. Paul Bacon, PHYSICAL THERAPIST	Physical Therapist	Emory	AI Deep Dive
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