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General NPI Number Information
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NPI Number | 1104337955
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Entity Type | Organization
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Legal Business Name | ACCIDENT AND INJURY CHIROPRATIC
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Dates
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Enumeration Date | 10/19/2017
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Last Update Date | 10/19/2017
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Provider Practice Location Address
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Address Line | 2525 W WHEATLAND RD STE 230
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City | DALLAS
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State | TX
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Zip | 75237-3502
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Country | US
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Telephone | 972-780-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 PEPPERWOOD ST APT 117
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City | FARMERS BRANCH
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State | TX
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Zip | 75234-6118
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Country | US
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Telephone | 469-363-7835
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | EDWARD AMADI
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Credential | DC
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Telephone | 469-363-7835
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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 | 13574
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License Number State | TX
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