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General NPI Number Information
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NPI Number | 1669990990
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Entity Type | Organization
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Legal Business Name | BORDER CITY CHIROPRACTIC
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Dates
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Enumeration Date | 09/07/2017
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Last Update Date | 09/07/2017
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Provider Practice Location Address
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Address Line | 2905 GENOA RD
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City | TEXARKANA
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State | AR
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Zip | 71854-9358
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Country | US
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Telephone | 903-826-3681
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Fax |
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Provider Business Mailing Address
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Address Line | 2905 GENOA RD
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City | TEXARKANA
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State | AR
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Zip | 71854-9358
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. HOLLY ELIZABETH CUNNINGHAM
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Credential | DC
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Telephone | 903-826-3681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 16104
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License Number State | AR
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