MEDICARE: WOODFOREST CHIROPRACTIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1073635504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODFOREST CHIROPRACTIC

Provider Business Mailing Address
First Line	:	735 N FIELDER RD STE A
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-4667
Country	:	US
Telephone Number	:	817-792-4080
Fax Number	:

Provider Business Practice Location Address
First Line	:	735 N FIELDER RD STE A
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-4667
Country	:	US
Telephone Number	:	817-792-4080
Fax Number	:

Authorized Official
Title or Position	:	BILLING AGENT
Name	:	RAYNA GENTRY
Credential	:
Telephone Number	:	817-987-1466

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	08/22/2020

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Directions to “WOODFOREST CHIROPRACTIC ” Practice Location

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