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General NPI Number Information
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NPI Number | 1710766167
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Entity Type | Organization
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Legal Business Name | T-SPINE CHIROPRACTIC AND REHABILITATION LLC
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Dates
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Enumeration Date | 09/25/2023
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 1018 E GOODE ST STE 102
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City | QUITMAN
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State | TX
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Zip | 75783-2563
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Country | US
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Telephone | 903-866-6505
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Fax | 903-763-2550
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Provider Business Mailing Address
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Address Line | 1018 E GOODE ST STE 102
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City | QUITMAN
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State | TX
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Zip | 75783-2563
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Country | US
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Telephone | 903-866-6505
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Fax | 903-763-2550
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. ROWDY TEAFF
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Credential | DC
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Telephone | 903-866-6505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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