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General NPI Number Information
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NPI Number | 1740360932
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Entity Type | Organization
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Legal Business Name | ACCIDENT & BACK PAIN CENTER
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 3304 SE LOOP 820
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City | FORT WORTH
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State | TX
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Zip | 76140-1108
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Country | US
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Telephone | 817-568-9200
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Fax | 817-568-8792
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Provider Business Mailing Address
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Address Line | 3304 SE LOOP 820
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City | FORT WORTH
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State | TX
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Zip | 76140-1108
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Country | US
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Telephone | 817-568-9200
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Fax | 817-568-8792
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Authorized Official
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Title or Position | REPRESENTATIVE
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Name | CINDY HAMMETT
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Credential |
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Telephone | 979-776-7300
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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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