East Texas Performance Rehabilitation INC

NPI #1205928561 in Longview, Texas

Provider Information

NPI Number: 1205928561
Entity Type: Organization
Organization Name: East Texas Performance Rehabilitation INC
Primary Specialty: Physical Therapist
Enumeration Date: Sep 28, 2006
Last Updated: Apr 17, 2008

Practice Location

Address: 434 EAST LOOP 281
Address 2: SUITE 103
City: Longview
State: Texas
ZIP Code: 75605
Phone: (903) 247-3422

Authorized Official

Name: MRS. ANDREE SIBILLE REYNOLDS, PHYSICAL THEREPIST
Title: PT OWNER
Phone: (903) 247-3244

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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