MEDICARE: CRT ENTERPRISES, INC

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	111NR0400X	Rehabilitation Chiropractor	10485	TX

General Provider Information

NPI Number	:	1558565689
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRT ENTERPRISES, INC

Provider Business Mailing Address
First Line	:	8845 DAVIS BLVD
Second Line	:	SUITE 100
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180
Country	:	US
Telephone Number	:	682-593-0500
Fax Number	:	682-593-0168

Provider Business Practice Location Address
First Line	:	8845 DAVIS BLVD
Second Line	:	SUITE 100
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180
Country	:	US
Telephone Number	:	682-593-0500
Fax Number	:	682-593-0168

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHRISTOPHER RYLEE
Credential	:	DC
Telephone Number	:	682-593-0500

Provider Enumeration Date	:	06/13/2007
Last Update Date	:	08/22/2020

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