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General NPI Number Information
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NPI Number | 1669512216
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Entity Type | Organization
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Legal Business Name | METROPLEX CHIROPRACTIC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4702 NORTHWEST HWY
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City | GARLAND
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State | TX
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Zip | 75043-4912
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Country | US
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Telephone | 972-686-7400
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Fax | 972-613-9390
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Provider Business Mailing Address
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Address Line | 4702 NORTHWEST HWY
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City | GARLAND
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State | TX
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Zip | 75043-4912
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Country | US
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Telephone | 972-686-7400
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Fax | 972-613-9390
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. GLEN RIC JOHNSON
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Credential | D.C.
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Telephone | 972-686-7400
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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 | 5567
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License Number State | TX
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