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General NPI Number Information
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NPI Number | 1093909905
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Entity Type | Organization
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Legal Business Name | NW MAIN CHIROPRACTIC, P.A.
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 11/06/2021
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Provider Practice Location Address
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Address Line | 109 NW MAIN ST
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City | ENNIS
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State | TX
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Zip | 75119-4053
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Country | US
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Telephone | 972-875-9377
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Fax | 972-875-4325
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Provider Business Mailing Address
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Address Line | 109 NW MAIN ST
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City | ENNIS
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State | TX
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Zip | 75119-4053
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Country | US
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Telephone | 972-875-9377
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Fax | 972-875-4325
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM C. DAVIS
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Credential | DC
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Telephone | 972-875-9377
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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 | 12144
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1044915
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 8285
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License Number State | TX
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