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General NPI Number Information
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NPI Number | 1174701924
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Entity Type | Organization
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Legal Business Name | ALVARADO CHIROPRACTIC HEALTH & WELLNESS
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Dates
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Enumeration Date | 02/04/2008
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Last Update Date | 02/04/2008
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Provider Practice Location Address
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Address Line | 805 E HWY 67
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City | ALVARADO
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State | TX
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Zip | 76009
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Country | US
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Telephone | 817-783-3500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1195
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City | GRANDVIEW
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State | TX
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Zip | 76050-1195
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Country | US
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Telephone | 817-783-3500
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Fax | 817-783-3502
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICK GAGICH
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Credential | DC
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Telephone | 817-783-3500
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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 | 8211
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License Number State | TX
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