Healthcare Provider Details

I. General information

NPI: 1497036438
Provider Name (Legal Business Name): MICHELLE LYNN SUMMERS D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2011
Last Update Date: 04/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 TEASLEY LN SUITE 402
DENTON TX
76210-8302
US

IV. Provider business mailing address

3201 TEASLEY LN STE 402
DENTON TX
76210-8305
US

V. Phone/Fax

Practice location:
  • Phone: 940-383-3420
  • Fax: 940-383-3432
Mailing address:
  • Phone: 559-972-1277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number11824
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: