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General NPI Number Information
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NPI Number | 1659646131
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Entity Type | Organization
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Legal Business Name | MASKE FAMILY CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 03/15/2012
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Last Update Date | 04/18/2013
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Provider Practice Location Address
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Address Line | 1514 N GREENVILLE AVE SUITE 340
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City | ALLEN
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State | TX
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Zip | 75002-1202
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Country | US
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Telephone | 214-842-2923
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Fax | 877-466-7919
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Provider Business Mailing Address
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Address Line | 1514 N GREENVILLE AVE SUITE 340
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City | ALLEN
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State | TX
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Zip | 75002-1202
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Country | US
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Telephone | 214-842-2923
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Fax | 877-466-7919
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | VANESSA THERESA MASKE
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Credential | D.C.
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Telephone | 214-842-2923
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 11555
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License Number State | TX
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