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General NPI Number Information
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NPI Number | 1700281003
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Entity Type | Individual
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Provider Name | JILL MARIE PLENTL D.C.
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Gender | Female
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Dates
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Enumeration Date | 10/29/2014
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Last Update Date | 04/22/2016
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Provider Practice Location Address
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Address Line | 781 LONESOME DOVE TRL STE B
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City | HURST
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State | TX
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Zip | 76054-6018
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Country | US
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Telephone | 817-656-4760
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Fax | 817-656-4761
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Provider Business Mailing Address
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Address Line | 831 N ATKERSON LN
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City | EULESS
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State | TX
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Zip | 76040-4707
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Country | US
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Telephone | 817-223-0759
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Fax | 817-656-4761
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 12729
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License Number State | TX
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