Sports, Back & Pain Mangement Clinic

NPI #1275786469 in Bryan, Texas

Provider Information

NPI Number: 1275786469
Entity Type: Organization
Organization Name: Sports, Back & Pain Mangement Clinic
Primary Specialty: Physical Therapist - Orthopedic
Enumeration Date: Oct 31, 2008
Last Updated: Oct 31, 2008

Practice Location

Address: 2011 #A VILLA MARIA RD
City: Bryan
State: Texas
ZIP Code: 77802-2541
Phone: (979) 776-2225

Authorized Official

Name: LEON F BRADWAY
Title: PHYSICAL THERAPIST
Phone: (979) 776-2225

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X
Physical Therapist - Electrophysiology, Clinical — Electrophysiology, Clinical	2251E1300X
Physical Therapist - Geriatrics — Geriatrics	2251G0304X
Physical Therapist - Human Factors — Human Factors	2251H1300X
Physical Therapist - Sports — Sports	2251S0007X
Physical Therapist - Orthopedic — Orthopedic	2251X0800X	Primary

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