Healthcare Provider Details

I. General information

NPI: 1396939211
Provider Name (Legal Business Name): NORTH RICHARDSON CHIROPRACTIC II, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 12/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7522 CAMPBELL RD SUITE 104
DALLAS TX
75248-1784
US

IV. Provider business mailing address

PO BOX 836383
RICHARDSON TX
75083-6383
US

V. Phone/Fax

Practice location:
  • Phone: 972-231-1900
  • Fax: 972-735-9972
Mailing address:
  • Phone: 972-231-1900
  • Fax: 972-735-9972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4359
License Number StateTX

VIII. Authorized Official

Name: DAVID SCOTT OLSON
Title or Position: PRESIDENT
Credential: D.C.
Phone: 972-231-1900