Most Relevant Information
Provider Data
| NPI Number: | 1003218843 |
| Provider Name: | STEPHEN BOSWORTH PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 2105157 |
Most Important Dates
| Enumeration Date: | 09/24/2014 |
| Last Updated: | 09/24/2014 |
Provider Practice Location
6767 9TH AVE
PORT ARTHUR
TX
776426414
Practice Location Phone/Fax
| Phone: | 4097221485 |
| Fax: |
Provider Mailing Location
6767 9TH AVE
PORT ARTHUR
TX
776426414
Provider Mailing Phone/Fax
| Phone: | 4097221485 |
| Fax: |