Provider Demographics
NPI:1437381068
Name:C & C THERAPY ALLIANCE, LLC
Entity Type:Organization
Organization Name:C & C THERAPY ALLIANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:URSULA
Authorized Official - Middle Name:
Authorized Official - Last Name:COPULOS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:512-659-8090
Mailing Address - Street 1:5708 TOSCANA AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78724-6185
Mailing Address - Country:US
Mailing Address - Phone:512-659-8090
Mailing Address - Fax:512-926-9997
Practice Address - Street 1:5708 TOSCANA AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78724-6185
Practice Address - Country:US
Practice Address - Phone:512-659-8090
Practice Address - Fax:512-926-9997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-16
Last Update Date:2009-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1152018225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty