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General NPI Number Information
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NPI Number | 1437430659
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Entity Type | Organization
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Legal Business Name | AUSTIN HILLSIDE FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 09/01/2011
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Last Update Date | 09/01/2011
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Provider Practice Location Address
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Address Line | 2941 W ANDERSON LN STE 2941
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City | AUSTIN
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State | TX
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Zip | 78757-1125
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Country | US
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Telephone | 304-208-0349
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Fax |
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Provider Business Mailing Address
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Address Line | 2941 W ANDERSON LN STE 2941
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City | AUSTIN
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State | TX
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Zip | 78757-1125
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Country | US
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Telephone | 304-208-0349
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIRPRACTOR
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Name | DR. DANIEL JOE DIERDORFF I
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Credential | D.C.
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Telephone | 304-208-0349
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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 | 11237
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License Number State | TX
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