Provider Demographics
NPI:1154863728
Name:GEYMER PHYSICAL THERAPY AND WELLNESS
Entity Type:Organization
Organization Name:GEYMER PHYSICAL THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:GEYMER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:817-201-9656
Mailing Address - Street 1:5728 MOON FLOWER CT
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-5189
Mailing Address - Country:US
Mailing Address - Phone:817-201-9656
Mailing Address - Fax:
Practice Address - Street 1:5728 MOON FLOWER CT
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-5189
Practice Address - Country:US
Practice Address - Phone:817-201-9656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-14
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1175541261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy