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General NPI Number Information
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NPI Number | 1700992476
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Entity Type | Organization
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Legal Business Name | MANSFIELD SPINAL CARE
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 1600 HIGHWAY 287 N SUITE 102
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City | MANSFIELD
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State | TX
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Zip | 76063-8853
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Country | US
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Telephone | 817-477-2907
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Fax | 817-473-3507
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Provider Business Mailing Address
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Address Line | 1600 HIGHWAY 287 N SUITE 102
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City | MANSFIELD
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State | TX
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Zip | 76063-8853
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Country | US
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Telephone | 817-477-2907
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Fax | 817-473-3507
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEITH N JENSEN
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Credential | D.C.
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Telephone | 817-477-2907
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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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