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General NPI Number Information
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NPI Number | 1376813998
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Entity Type | Organization
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Legal Business Name | DICKINSON FAMILY CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 03/02/2012
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Provider Practice Location Address
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Address Line | 28105 TOMBALL PKWY SUITE 106A
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City | TOMBALL
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State | TX
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Zip | 77375-3340
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Country | US
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Telephone | 832-341-7047
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Fax |
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Provider Business Mailing Address
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Address Line | 28105 TOMBALL PKWY SUITE 106A
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City | TOMBALL
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State | TX
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Zip | 77375-3340
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Country | US
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Telephone | 832-341-7047
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. COURTNEY BROOKE DICKINSON
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Credential | D.C.
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Telephone | 832-341-7047
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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 | 11730
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License Number State | TX
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