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General NPI Number Information
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NPI Number | 1265982656
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Entity Type | Organization
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Legal Business Name | FAMILY LIFE CHIROPRACTIC, INC
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Dates
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Enumeration Date | 10/10/2016
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Last Update Date | 04/11/2017
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Provider Practice Location Address
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Address Line | 3730 N JOSEY LN #122
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City | CARROLLTON
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State | TX
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Zip | 75007-2484
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Country | US
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Telephone | 940-867-6563
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Fax |
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Provider Business Mailing Address
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Address Line | 3730 N JOSEY LN #122
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City | CARROLLTON
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State | TX
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Zip | 75007-2484
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Country | US
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Telephone | 940-867-6563
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT/CHIROPRACTOR
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Name | EMILEE HARRIS
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Credential | D.C.
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Telephone | 940-867-6563
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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 | 13187
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License Number State | TX
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