Provider Demographics
NPI:1265114508
Name:TOTAL PHYSICAL THERAPY & REHAB
Entity type:Organization
Organization Name:TOTAL PHYSICAL THERAPY & REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BRUNNER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:979-665-8888
Mailing Address - Street 1:9036 COUNTY ROAD 628
Mailing Address - Street 2:
Mailing Address - City:BRAZORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77422-6640
Mailing Address - Country:US
Mailing Address - Phone:979-665-8888
Mailing Address - Fax:
Practice Address - Street 1:301 DANCE DR
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:TX
Practice Address - Zip Code:77486-4015
Practice Address - Country:US
Practice Address - Phone:979-665-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty