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General NPI Number Information
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NPI Number | 1295841070
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Entity Type | Organization
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Legal Business Name | ADVANCED WELLNESS AND REHAB CENTER
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 6029 BELT LINE RD STE 100
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City | DALLAS
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State | TX
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Zip | 75254-9137
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Country | US
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Telephone | 972-392-7008
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Fax | 972-392-1171
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Provider Business Mailing Address
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Address Line | 6029 BELT LINE RD STE 100
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City | DALLAS
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State | TX
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Zip | 75254-9137
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Country | US
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Telephone | 972-392-7008
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Fax | 972-392-1171
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS CORINNA CARLA JUMAO-AS
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Credential | OT
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Telephone | 972-392-7008
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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 | DC4635
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | DC4635
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | DC4635
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 111489
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License Number State | TX
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