Provider Demographics
NPI:1952843427
Name:VADDCARM LLC
Entity Type:Organization
Organization Name:VADDCARM LLC
Other - Org Name:FYZICAL THERAPY & BALANCE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER/OPERATOR
Authorized Official - Phone:713-294-9766
Mailing Address - Street 1:15210 INTERSTATE 45 SOUTH
Mailing Address - Street 2:SUITE 108
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384
Mailing Address - Country:US
Mailing Address - Phone:832-702-7272
Mailing Address - Fax:832-702-7255
Practice Address - Street 1:15210 INTERSTATE 45 S
Practice Address - Street 2:SUITE 108
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-4105
Practice Address - Country:US
Practice Address - Phone:832-702-7272
Practice Address - Fax:832-702-7255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1048759225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty