| NPI | 1982065827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA CAMILLE TIBBITS Owner 469-454-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 13046) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 11783) |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2022-06-10 |