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General NPI Number Information
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NPI Number | 1255612719
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Entity Type | Organization
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Legal Business Name | ELEVATION CHIROPRACTIC
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Dates
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Enumeration Date | 08/29/2011
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Last Update Date | 10/12/2011
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Provider Practice Location Address
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Address Line | 4150 W ELDORADO PKWY STE 200
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City | MCKINNEY
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State | TX
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Zip | 75070-4531
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Country | US
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Telephone | 972-540-5333
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Fax |
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Provider Business Mailing Address
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Address Line | 4150 W ELDORADO PKWY STE 200
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City | MCKINNEY
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State | TX
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Zip | 75070-4531
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Country | US
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Telephone | 972-540-5333
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. CHRISTOPHER MARION KORDIC
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Credential | D.C.
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Telephone | 972-540-5333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 11801
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License Number State | TX
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