Provider Demographics
NPI:1164963807
Name:CLT RENTALS, LLC
Entity Type:Organization
Organization Name:CLT RENTALS, LLC
Other - Org Name:CROSS LINE THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:W
Authorized Official - Last Name:TIPPING
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:682-472-0161
Mailing Address - Street 1:990 HIGHWAY 287 N
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-2607
Mailing Address - Country:US
Mailing Address - Phone:682-472-0161
Mailing Address - Fax:888-247-9848
Practice Address - Street 1:990 HIGHWAY 287 N
Practice Address - Street 2:SUITE 105
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2607
Practice Address - Country:US
Practice Address - Phone:682-472-0161
Practice Address - Fax:888-247-9848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX681470000261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy