TACKETT CUSTOM MEDICINE

WEATHERFORD, TX
NPI1497009583
Entity TypeOrganization
Authorized ContactDAVID ROGER MORRIS
PIC
817-441-7046
Organization Subpart ?No
Primary Taxonomy261Q00000X Clinic/Center
(Licence: TX  28226)
Enumeration Date2012-10-29
Last Update Date2012-10-29
Business Address
TACKETT CUSTOM MEDICINE
175 COLLEGE PARK DR
WEATHERFORD, TX 76086-6211
Phone number: 817-550-6046
Mailing Address
TACKETT CUSTOM MEDICINE
132 EL CHICO TRL
WILLOW PARK, TX 76087-8865
Phone number: 817-441-7046
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