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General NPI Number Information
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NPI Number | 1235777467
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Entity Type | Organization
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Legal Business Name | FUNCTIONAL AIM CHIROPRACTIC
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Dates
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Enumeration Date | 12/18/2019
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Last Update Date | 12/18/2019
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Provider Practice Location Address
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Address Line | 7300 BLANCO RD STE 503
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City | SAN ANTONIO
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State | TX
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Zip | 78216-4941
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Country | US
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Telephone | 469-265-8591
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Fax |
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Provider Business Mailing Address
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Address Line | 5307 ARGYLE WAY
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City | SAN ANTONIO
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State | TX
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Zip | 78247-5812
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Country | US
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Telephone | 469-265-8591
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PETER BURNS
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Credential | DC
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Telephone | 469-265-8591
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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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