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General NPI Number Information
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NPI Number | 1366899833
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Entity Type | Organization
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Legal Business Name | CHIROHEALTH MEDICAL AND ANCILLARY SERVICES, LLC
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Dates
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Enumeration Date | 05/15/2016
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Last Update Date | 06/08/2017
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Provider Practice Location Address
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Address Line | 4112 LEGACY DR STE 326
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City | FRISCO
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State | TX
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Zip | 75034-0811
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Country | US
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Telephone | 214-872-1232
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Fax |
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Provider Business Mailing Address
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Address Line | 4112 LEGACY DR SUITE 326
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City | FRISCO
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State | TX
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Zip | 75034-0810
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Country | US
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Telephone | 214-872-1232
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Fax |
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Authorized Official
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Title or Position | PRESIDENT, PROVIDER
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Name | MEE OK KIM
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Credential | FNP-C
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Telephone | 214-872-1232
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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 | AP123278
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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