Provider Demographics
NPI:1962992099
Name:FREE RANGE PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:FREE RANGE PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:OSORIA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CKTP
Authorized Official - Phone:830-931-7277
Mailing Address - Street 1:451 PRIVATE ROAD 5769
Mailing Address - Street 2:
Mailing Address - City:CASTROVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78009-2157
Mailing Address - Country:US
Mailing Address - Phone:830-931-7277
Mailing Address - Fax:830-202-5408
Practice Address - Street 1:451 PRIVATE ROAD 5769
Practice Address - Street 2:
Practice Address - City:CASTROVILLE
Practice Address - State:TX
Practice Address - Zip Code:78009-2157
Practice Address - Country:US
Practice Address - Phone:830-931-7277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-15
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1191653261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy