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General NPI Number Information
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NPI Number | 1023131430
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Entity Type | Organization
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Legal Business Name | TRICOUNTY COUNTY CHIROPRACTIC
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 01/12/2014
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Provider Practice Location Address
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Address Line | 5612 SW GREEN OAKS BLVD STE B
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City | ARLINGTON
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State | TX
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Zip | 76017-1154
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Country | US
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Telephone | 817-676-3987
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Fax |
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Provider Business Mailing Address
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Address Line | 5612 SW GREEN OAKS BLVD STE B
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City | ARLINGTON
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State | TX
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Zip | 76017-1154
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Country | US
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Telephone | 817-676-3987
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Fax |
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Authorized Official
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Title or Position | BILLING AGENT
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Name | RAYNA MILES
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Credential |
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Telephone | 817-932-7066
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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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