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General NPI Number Information
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NPI Number | 1699042762
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Entity Type | Organization
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Legal Business Name | STACEY KING DC PLLC
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Dates
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Enumeration Date | 11/17/2011
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Last Update Date | 11/17/2011
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Provider Practice Location Address
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Address Line | 1720 N 1ST ST STE A
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City | GARLAND
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State | TX
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Zip | 75040-4702
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Country | US
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Telephone | 214-364-1020
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Fax | 972-303-9189
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Provider Business Mailing Address
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Address Line | 1720 N 1ST ST STE A
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City | GARLAND
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State | TX
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Zip | 75040-4702
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Country | US
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Telephone | 214-364-1020
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Fax | 972-303-9189
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Authorized Official
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Title or Position | OWNER
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Name | STACEY KING
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Credential | DC
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Telephone | 214-364-1020
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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 | 08164
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License Number State | TX
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