Provider Demographics
NPI:1265989271
Name:PETREE AND HEARNE THERAPY ENTERPRISES, PLLC
Entity type:Organization
Organization Name:PETREE AND HEARNE THERAPY ENTERPRISES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPY ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:PETREE
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:254-631-7503
Mailing Address - Street 1:200 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CISCO
Mailing Address - State:TX
Mailing Address - Zip Code:76437-3023
Mailing Address - Country:US
Mailing Address - Phone:254-631-7503
Mailing Address - Fax:
Practice Address - Street 1:200 W 8TH ST
Practice Address - Street 2:
Practice Address - City:CISCO
Practice Address - State:TX
Practice Address - Zip Code:76437-3023
Practice Address - Country:US
Practice Address - Phone:254-631-7503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy