| NPI | 1578736567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM BOB HAGGERTON Owner 817-428-9595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 9744) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 10827) |
| 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: TX 10073) | |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2016-03-04 |