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General NPI Number Information
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NPI Number | 1154012805
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Entity Type | Organization
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Legal Business Name | OUR LIGHT CHIROPRACTIC LLC
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Dates
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Enumeration Date | 05/15/2023
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 870 N COIT RD STE 2651
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City | RICHARDSON
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State | TX
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Zip | 75080-6214
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Country | US
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Telephone | 469-298-8297
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Fax |
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Provider Business Mailing Address
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Address Line | 870 N COIT RD STE 2651
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City | RICHARDSON
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State | TX
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Zip | 75080-6214
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Country | US
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Telephone | 469-298-8297
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. BRITTANY CLAUS
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Credential | DC
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Telephone | 682-219-9314
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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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