Healthcare Provider Details

I. General information

NPI: 1447283338
Provider Name (Legal Business Name): JIMMY T. RULAND D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 06/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 WESTERN CENTER BLVD
FORT WORTH TX
76137-1936
US

IV. Provider business mailing address

PO BOX 121309
FORT WORTH TX
76121-1309
US

V. Phone/Fax

Practice location:
  • Phone: 817-498-7333
  • Fax: 817-581-2866
Mailing address:
  • Phone: 817-498-7333
  • Fax: 817-581-2866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6175
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: