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General NPI Number Information
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NPI Number | 1467755892
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Entity Type | Organization
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Legal Business Name | WILLIAM S. UTHLAUT D.C.,P.C.
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Dates
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Enumeration Date | 12/07/2010
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Last Update Date | 07/25/2011
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Provider Practice Location Address
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Address Line | 6450 BROADWAY BLVD
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City | GARLAND
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State | TX
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Zip | 75043-5943
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Country | US
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Telephone | 972-226-2225
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Fax | 972-226-2238
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Provider Business Mailing Address
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Address Line | 6450 BROADWAY BLVD
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City | GARLAND
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State | TX
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Zip | 75043-5943
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Country | US
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Telephone | 972-226-2225
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Fax | 972-226-2238
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM STAFFORD UTHLAUT
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Credential | D.C.
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Telephone | 972-226-2225
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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 | 2856
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License Number State | TX
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