Provider Demographics
NPI:1295379147
Name:HART ROCKFORD, TIFFANY N (DPT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:N
Last Name:HART ROCKFORD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:N
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2851 MATLOCK RD STE 600
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5039
Mailing Address - Country:US
Mailing Address - Phone:817-473-6246
Mailing Address - Fax:817-473-2014
Practice Address - Street 1:2851 MATLOCK RD STE 600
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-5039
Practice Address - Country:US
Practice Address - Phone:817-473-6246
Practice Address - Fax:817-473-2014
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1262811225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist