MEDICARE: LOVELACE CHIROPRACTIC AND SPORTS REHAB

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	261QH0100X	Health Service Clinic/Center	12657	TX

General Provider Information

NPI Number	:	1306252796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVELACE CHIROPRACTIC AND SPORTS REHAB

Provider Business Mailing Address
First Line	:	12800 PRESTON RD STE 200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-1369
Country	:	US
Telephone Number	:	214-536-2423
Fax Number	:

Provider Business Practice Location Address
First Line	:	12800 PRESTON RD STE 200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-1369
Country	:	US
Telephone Number	:	214-536-2423
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. COLBY LOVELACE
Credential	:	D.C
Telephone Number	:	214-797-5944

Provider Enumeration Date	:	07/07/2014
Last Update Date	:	07/08/2014

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Directions to “LOVELACE CHIROPRACTIC AND SPORTS REHAB ” Practice Location

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