Provider Demographics
NPI:1265165815
Name:STORB, NATHAN WILLIAM (PT, DPT, CSRS)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:WILLIAM
Last Name:STORB
Suffix:
Gender:M
Credentials:PT, DPT, CSRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27439 RIO CIR
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78015-5087
Mailing Address - Country:US
Mailing Address - Phone:267-463-3461
Mailing Address - Fax:
Practice Address - Street 1:27439 RIO CIR
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78015-5087
Practice Address - Country:US
Practice Address - Phone:267-463-3461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1270381225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist