Provider Demographics
NPI:1871803445
Name:REACTION PHYSICAL THERAPY,LLC
Entity type:Organization
Organization Name:REACTION PHYSICAL THERAPY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLC MEMBER/CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:CENICEROS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:915-345-7306
Mailing Address - Street 1:2270 JOE BATTLE BLVD STE R
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-2610
Mailing Address - Country:US
Mailing Address - Phone:915-855-7780
Mailing Address - Fax:915-855-7781
Practice Address - Street 1:2270 JOE BATTLE BLVD STE R
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-2610
Practice Address - Country:US
Practice Address - Phone:915-855-7780
Practice Address - Fax:915-855-7781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1038982225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty