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General NPI Number Information
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NPI Number | 1679445795
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Entity Type | Organization
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Legal Business Name | EQUINOX WELLNESS CENTER INC
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 1334 E PIONEER PKWY STE A
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City | ARLINGTON
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State | TX
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Zip | 76010-6411
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Country | US
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Telephone | 817-801-7300
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Fax | 888-549-2996
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Provider Business Mailing Address
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Address Line | 1334 E PIONEER PKWY STE A
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City | ARLINGTON
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State | TX
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Zip | 76010-6411
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Country | US
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Telephone | 817-801-7300
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Fax | 888-549-2996
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Authorized Official
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Title or Position | CEO
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Name | VIAN BOUTALOTH
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Credential |
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Telephone | 817-801-7300
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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 |
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License Number State |
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