Provider Demographics
NPI:1366708562
Name:CONNECTED 2 THERAPY
Entity type:Organization
Organization Name:CONNECTED 2 THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR / HEAD THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:LANDRIE
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:JOHANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:855-339-6978
Mailing Address - Street 1:2707 N STEMMONS FWY
Mailing Address - Street 2:SUITE 245
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75207-2281
Mailing Address - Country:US
Mailing Address - Phone:855-339-6978
Mailing Address - Fax:855-329-6978
Practice Address - Street 1:2707 N STEMMONS FWY
Practice Address - Street 2:SUITE 245
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-2281
Practice Address - Country:US
Practice Address - Phone:855-339-6978
Practice Address - Fax:855-329-6978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX672130000261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy