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General NPI Number Information
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NPI Number | 1023561750
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Entity Type | Organization
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Legal Business Name | WEST END CHIROPRACTIC AUSTIN LLC
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Dates
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Enumeration Date | 07/29/2016
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | 1611 W 5TH ST STE 110
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City | AUSTIN
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State | TX
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Zip | 78703-4889
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Country | US
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Telephone | 512-472-1116
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Fax | 512-472-1171
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Provider Business Mailing Address
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Address Line | 1611 W 5TH ST STE 110
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City | AUSTIN
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State | TX
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Zip | 78703-4889
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Country | US
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Telephone | 512-472-1116
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Fax | 512-472-1171
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Authorized Official
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Title or Position | PRESIDENT
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Name | CASEY MORGAN
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Credential | DC
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Telephone | 512-472-1116
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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 | 12254
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License Number State | TX
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