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General NPI Number Information
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NPI Number | 1093880056
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Entity Type | Organization
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Legal Business Name | CANUSA ENTERPRISE
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 1940 WEST FM 407 STE 110
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City | HIGHLAND VILLAGE
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State | TX
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Zip | 75077-2152
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Country | US
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Telephone | 972-966-6996
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Fax | 972-966-6966
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Provider Business Mailing Address
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Address Line | 1940 WEST FM 407 STE 110
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City | HIGHLAND VILLAGE
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State | TX
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Zip | 75077-2152
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Country | US
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Telephone | 972-966-6996
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Fax | 972-966-6966
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JURE MARENIC
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Credential | D.C.
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Telephone | 972-966-6996
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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 | 9031
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 9028
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License Number State | TX
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