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General NPI Number Information
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NPI Number | 1194901918
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Entity Type | Organization
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Legal Business Name | KAMALI CHIROPRACTIC
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 01/10/2008
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Provider Practice Location Address
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Address Line | 950 SOUTH HIGHWAY 156 #10
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City | JUSTIN
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State | TX
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Zip | 76247
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Country | US
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Telephone | 940-242-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 3720 PALM DRIVE
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City | KELLER
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State | TX
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Zip | 76248
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Country | US
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Telephone | 940-242-0300
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Fax | 940-242-0278
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MOJGAN KAMALI
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Credential | DC
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Telephone | 940-242-0300
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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 | 9971
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License Number State | TX
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