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General NPI Number Information
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NPI Number | 1235416900
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Entity Type | Organization
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Legal Business Name | PECAN VALLEY CHIROPRACTIC & REHAB, LLC
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Dates
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Enumeration Date | 11/09/2011
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Last Update Date | 11/09/2011
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Provider Practice Location Address
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Address Line | 801 EARLY BLVD SUITE 100
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City | EARLY
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State | TX
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Zip | 76802-2130
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Country | US
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Telephone | 325-646-8237
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Fax | 325-643-9856
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Provider Business Mailing Address
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Address Line | 801 EARLY BLVD SUITE 100
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City | EARLY
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State | TX
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Zip | 76802-2130
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Country | US
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Telephone | 325-646-8237
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Fax | 325-643-9856
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID KENT SCHUM
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Credential | D.C.
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Telephone | 325-646-8237
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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 | 5772
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License Number State | TX
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