Provider Demographics
NPI:1891707329
Name:PHYSICAL THERAPY DYNAMICS, PLLC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY DYNAMICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:CONRAD
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:817-297-9670
Mailing Address - Street 1:775 E FM 1187
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-2706
Mailing Address - Country:US
Mailing Address - Phone:817-297-9670
Mailing Address - Fax:817-277-5103
Practice Address - Street 1:775 E FM 1187
Practice Address - Street 2:SUITE 4
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036
Practice Address - Country:US
Practice Address - Phone:817-297-9670
Practice Address - Fax:817-277-5103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2022-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty