Basic Information
| Provider Information | |||||||||
| NPI: | 1093311169 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AIRROSTI PT, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 TOWER DR BLDG 1 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782323625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8663109123 | ||||||||
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| Practice Location | |||||||||
| Address1: | 111 TOWER DR BLDG 1 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782323625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004046050 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2020 | ||||||||
| LastUpdateDate: | 12/02/2021 | ||||||||
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| AuthorizedOfficialLastName: | WISSEL-LITTMANN | ||||||||
| AuthorizedOfficialFirstName: | JEFFREY | ||||||||
| AuthorizedOfficialMiddleName: | G | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT & ASSISTANT SECRETARY | ||||||||
| AuthorizedOfficialTelephone: | 8004046050 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
| NPICertificationDate: | 12/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.