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General NPI Number Information
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NPI Number | 1164557286
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Entity Type | Organization
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Legal Business Name | WALNUT HILL CHIROPRACTIC CLINIC, INC.
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10016 MONROE DR
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City | DALLAS
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State | TX
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Zip | 75229-5703
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Country | US
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Telephone | 214-351-1211
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Fax |
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Provider Business Mailing Address
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Address Line | 1919 VETERANS BOULEVARD SUITE 200
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City | KENNER
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State | LA
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Zip | 70062
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | BUFFIE L ROME IV
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Credential |
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Telephone | 504-467-0302
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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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