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General NPI Number Information
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NPI Number | 1376729731
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Entity Type | Organization
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Legal Business Name | TWO STOREY CHIROPRACTIC PA
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 03/16/2012
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Provider Practice Location Address
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Address Line | 2412 COLLEGE HILLS BLVD STE 206
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City | SAN ANGELO
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State | TX
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Zip | 76904-8425
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Country | US
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Telephone | 325-949-1518
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Fax | 325-223-9290
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Provider Business Mailing Address
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Address Line | 2412 COLLEGE HILLS BLVD STE 206
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City | SAN ANGELO
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State | TX
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Zip | 76904-8425
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Country | US
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Telephone | 325-949-1518
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Fax | 325-223-9290
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BENJAMIN STOREY
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Credential | D.C.
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Telephone | 325-949-1518
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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 | 7343
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License Number State | TX
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