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General NPI Number Information
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NPI Number | 1265103618
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Entity Type | Organization
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Legal Business Name | PURE ENERGY CHIROPRACTIC
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Dates
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Enumeration Date | 09/24/2021
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Last Update Date | 09/24/2021
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Provider Practice Location Address
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Address Line | 2304 HANCOCK DR STE 7
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City | AUSTIN
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State | TX
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Zip | 78756-2540
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Country | US
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Telephone | 801-673-2027
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Fax |
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Provider Business Mailing Address
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Address Line | 141 SANGAREE DR
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City | BUDA
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State | TX
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Zip | 78610-2154
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Country | US
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Telephone | 801-672-2027
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. ROANNE EPPS
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Credential | D.C.
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Telephone | 801-673-2027
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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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