| Northwest Physical Therapy Inc | |
|
408 Central Dr, Azle, TX 76020-3140 | |
| (817) 444-8827 | |
| Not Available |
| Full Name | Northwest Physical Therapy Inc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 408 Central Dr, Azle, Texas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114507852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Secondary |
| Provider Name | Shane Bradley Wall |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992287619 PECOS PAC ID: 7113326083 Enrollment ID: I20210526000048 |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Physical Therapy Inc 133 Single Tree Rd, Decatur, TX 76234-1850 Ph: (254) 592-0418 | Northwest Physical Therapy Inc 408 Central Dr, Azle, TX 76020-3140 Ph: (817) 444-8827 |
Caitlynn Perry, DPY Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 245 W Main St, Azle, TX 76020 Phone: 817-270-2975 Fax: 817-270-3596 | |
Kody Smith, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 245 W Main St, Azle, TX 76020 Phone: 817-270-2975 Fax: 817-270-3596 | |
Kelsey Robers, Physical Therapist Medicare: Medicare Enrolled Practice Location: 613 Profit St, Azle, TX 76020 Phone: 682-453-7102 | |
Jeremy Corbin, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 137 Industrial Ave, Azle, TX 76020 Phone: 817-270-2975 Fax: 817-370-9891 | |
Jessica Pierce, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 245 W Main St, Azle, TX 76020 Phone: 817-270-2975 Fax: 817-270-3596 | |
Dr. Alex Gustaf, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 613 Profit St, Azle, TX 76020 Phone: 682-453-7102 Fax: 817-665-3815 |