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General NPI Number Information
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NPI Number | 1619169778
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Entity Type | Organization
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Legal Business Name | HOMBRE ROSE INC
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 01/29/2016
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Provider Practice Location Address
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Address Line | 1011 W WALL ST
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City | GRAPEVINE
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State | TX
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Zip | 76051-5151
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Country | US
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Telephone | 817-329-8393
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Fax | 817-416-6263
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Provider Business Mailing Address
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Address Line | 1011 W WALL ST
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City | GRAPEVINE
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State | TX
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Zip | 76051-5151
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Country | US
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Telephone | 817-329-8393
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Fax | 817-416-6263
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CURTIS RATLIFF
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Credential | D.C.
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Telephone | 817-329-8393
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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 | 4698
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License Number State | TX
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