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General NPI Number Information
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NPI Number | 1457006983
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Entity Type | Organization
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Legal Business Name | LEVEL UP CHIROPRACTIC AND WELLNESS
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 4300 N CENTRAL EXPY STE 290
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City | DALLAS
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State | TX
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Zip | 75206-6532
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Country | US
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Telephone | 727-517-6389
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Fax |
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Provider Business Mailing Address
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Address Line | 2825 REAGAN ST APT A
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City | DALLAS
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State | TX
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Zip | 75219-7114
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Country | US
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Telephone | 727-517-6389
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Fax |
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Authorized Official
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Title or Position | CEO / CHIROPRACTOR
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Name | DR. NORMAN ALBERTO QUINTERO III
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Credential | DC
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Telephone | 727-517-6389
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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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