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General NPI Number Information
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NPI Number | 1013778794
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Entity Type | Organization
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Legal Business Name | CHIRO CONNECT INJURY REHAB LLC
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Dates
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Enumeration Date | 01/19/2024
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Last Update Date | 01/19/2024
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Provider Practice Location Address
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Address Line | 285 N INTERSTATE 35 E
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City | DESOTO
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State | TX
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Zip | 75115-5299
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Country | US
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Telephone | 469-613-4452
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Fax | 469-898-4313
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Provider Business Mailing Address
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Address Line | 225 HAPPY LN
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City | RED OAK
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State | TX
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Zip | 75154-8858
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Country | US
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Telephone | 469-358-7991
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHADANA HILL
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Credential | D.C.
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Telephone | 469-358-7991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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