Healthcare Provider Details

I. General information

NPI: 1891123311
Provider Name (Legal Business Name): DOWNTOWN CHIROPRACTIC, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2013
Last Update Date: 10/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N SAINT PAUL ST SUITE 200
DALLAS TX
75201-3114
US

IV. Provider business mailing address

1018 E 22ND AVE
NORTH KANSAS CITY MO
64116-3315
US

V. Phone/Fax

Practice location:
  • Phone: 214-954-4357
  • Fax:
Mailing address:
  • Phone: 816-888-9524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number21444
License Number StateTX

VIII. Authorized Official

Name: DR. MARTIN MATTHEW POWERS
Title or Position: PRESIDENT
Credential: DC
Phone: 214-954-4357