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General NPI Number Information
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NPI Number | 1639463128
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Entity Type | Organization
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Legal Business Name | SQUYRES INVESTMENTS LLC
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Dates
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Enumeration Date | 06/02/2011
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Last Update Date | 02/06/2014
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Provider Practice Location Address
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Address Line | 204 N JACKSON AVE
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City | JUSTIN
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State | TX
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Zip | 76247-9582
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Country | US
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Telephone | 940-441-9285
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Fax | 940-538-5393
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Provider Business Mailing Address
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Address Line | 204 N JACKSON AVE
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City | JUSTIN
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State | TX
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Zip | 76247-9582
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Country | US
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Telephone | 940-441-9285
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Fax | 940-538-5393
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | JASON CODY SQUYERS
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Credential | DC
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Telephone | 940-441-9285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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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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