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NPI 1396390977

NPI 1396390977 : ARUBAH WELLNESS GROUP : DUNCANVILLE, TX

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General NPI Number Information
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    NPI Number           |    1396390977
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    Entity Type          |    Organization 
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    Legal Business Name  |    ARUBAH WELLNESS GROUP 
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Dates
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    Enumeration Date     |    08/09/2019
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    Last Update Date     |    11/26/2019
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Provider Practice Location Address
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    Address Line         |    1414 W WHEATLAND RD STE 103 
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    City                 |    DUNCANVILLE
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    State                |    TX
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    Zip                  |    75116-4249
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    Country              |    US
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    Telephone            |    972-232-7129
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1414 W WHEATLAND RD STE 103 
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    City                 |    DUNCANVILLE
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    State                |    TX
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    Zip                  |    75116-4249
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    Country              |    US
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    Telephone            |    
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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. TANYA NICOLE MCCLENDON 
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    Credential           |    DC
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    Telephone            |    972-232-7129
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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       |    
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    License Number State |    
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