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General NPI Number Information
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NPI Number | 1407230816
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Entity Type | Organization
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Legal Business Name | GARLAND WELLNESS & REHAB CENTER, LLC
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Dates
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Enumeration Date | 07/15/2015
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Last Update Date | 07/15/2015
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Provider Practice Location Address
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Address Line | 3112 N JUPITER RD STE 310
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City | GARLAND
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State | TX
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Zip | 75044-6564
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Country | US
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Telephone | 972-496-7070
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Fax | 972-496-7072
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Provider Business Mailing Address
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Address Line | 3112 N JUPITER RD STE 310
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City | GARLAND
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State | TX
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Zip | 75044-6564
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Country | US
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Telephone | 972-496-7070
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Fax | 972-496-7072
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. ALEXANDER PHAM
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Credential | D,C
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Telephone | 972-496-7070
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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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