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General NPI Number Information
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NPI Number | 1750333860
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Entity Type | Organization
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Legal Business Name | CANTON CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 430 S TRADE DAYS BLVD
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City | CANTON
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State | TX
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Zip | 75103-3302
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Country | US
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Telephone | 903-567-6106
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Fax | 906-567-5115
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Provider Business Mailing Address
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Address Line | PO BOX 226656
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City | DALLAS
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State | TX
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Zip | 75222-6656
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Country | US
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Telephone | 903-567-6106
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Fax | 903-567-5115
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOHN ZACHARIAS
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Credential |
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Telephone | 214-943-9431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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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