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General NPI Number Information
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NPI Number | 1710484597
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Entity Type | Organization
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Legal Business Name | EPIC CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 04/09/2018
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Last Update Date | 01/06/2022
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Provider Practice Location Address
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Address Line | 5318 114TH ST
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City | LUBBOCK
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State | TX
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Zip | 79424-6621
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Country | US
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Telephone | 806-783-0644
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Fax | 806-224-0428
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Provider Business Mailing Address
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Address Line | 5318 114TH ST
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City | LUBBOCK
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State | TX
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Zip | 79424-6621
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Country | US
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Telephone | 806-783-0644
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Fax | 806-224-0428
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. COURTNEY D SPROUL
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Credential | DC
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Telephone | 806-783-0644
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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 | 13703
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License Number State | TX
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