Provider Demographics
NPI:1194359232
Name:INTEGRATIVE FUNCTIONAL PERFORMANCE, PLLC
Entity Type:Organization
Organization Name:INTEGRATIVE FUNCTIONAL PERFORMANCE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-620-0494
Mailing Address - Street 1:8109 RIVERWALK TRL
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8557
Mailing Address - Country:US
Mailing Address - Phone:508-733-9802
Mailing Address - Fax:
Practice Address - Street 1:8109 RIVERWALK TRL
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-8557
Practice Address - Country:US
Practice Address - Phone:214-620-0494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy