Provider Demographics
NPI:1356974638
Name:AT HOME PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:AT HOME PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CASIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLOMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-734-5421
Mailing Address - Street 1:836 E REYNOSA AVE
Mailing Address - Street 2:
Mailing Address - City:DE LEON
Mailing Address - State:TX
Mailing Address - Zip Code:76444-2029
Mailing Address - Country:US
Mailing Address - Phone:254-734-5421
Mailing Address - Fax:254-893-7955
Practice Address - Street 1:836 E REYNOSA AVE
Practice Address - Street 2:
Practice Address - City:DE LEON
Practice Address - State:TX
Practice Address - Zip Code:76444-2029
Practice Address - Country:US
Practice Address - Phone:254-734-5421
Practice Address - Fax:254-893-7955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-14
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty