| NPI | 1104281161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY LEVINGSTON Director 469-587-9614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 13079) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: TX 13079) |
| 111NR0400X Chiropractor, Rehabilitation (Licence: TX 13079) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: TX 13079) | |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2015-12-17 |