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General NPI Number Information
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NPI Number | 1194947234
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Entity Type | Organization
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Legal Business Name | LANE CHIROPRACTICE CLINIC, PC
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 10/02/2008
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Provider Practice Location Address
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Address Line | 13520 T I BLVD STE 110
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City | DALLAS
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State | TX
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Zip | 75243-1563
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Country | US
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Telephone | 972-671-1158
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Fax |
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Provider Business Mailing Address
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Address Line | 13520 T I BLVD STE 110
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City | DALLAS
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State | TX
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Zip | 75243-1563
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Country | US
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Telephone | 972-671-1158
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. CAMERON PAUL LABORET
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Credential | DC
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Telephone | 972-671-5263
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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 | 7157
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License Number State | TX
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