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General NPI Number Information
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NPI Number | 1417476268
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Entity Type | Organization
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Legal Business Name | SAN ANTONIO ELITE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 09/13/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2397 NW MILITARY HWY STE D
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City | SAN ANTONIO
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State | TX
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Zip | 78231-2543
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Country | US
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Telephone | 210-342-3507
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Fax |
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Provider Business Mailing Address
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Address Line | 2397 NW MILITARY HWY STE D
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City | SAN ANTONIO
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State | TX
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Zip | 78231-2543
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Country | US
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Telephone | 210-342-3507
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MATTHEW JAMES
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Credential | DC
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Telephone | 830-822-2953
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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 | 13219
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License Number State | TX
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