Provider Demographics
NPI:1275394025
Name:PT OT CONNECT
Entity Type:Organization
Organization Name:PT OT CONNECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHANOI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, OT
Authorized Official - Phone:915-538-9552
Mailing Address - Street 1:528 LA CANTERA DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-2542
Mailing Address - Country:US
Mailing Address - Phone:915-538-9552
Mailing Address - Fax:
Practice Address - Street 1:528 LA CANTERA DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-2542
Practice Address - Country:US
Practice Address - Phone:915-538-9552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty