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General NPI Number Information
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NPI Number | 1750583282
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Entity Type | Organization
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Legal Business Name | COMPLETE CARE CHIROPRACTIC
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 04/27/2012
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Provider Practice Location Address
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Address Line | 3965 PHELAN BLVD SUITE 109
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City | BEAUMONT
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State | TX
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Zip | 77707
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Country | US
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Telephone | 409-835-7676
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Fax | 409-835-5106
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Provider Business Mailing Address
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Address Line | 3965 PHELAN BLVD SUITE 109
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City | BEAUMONT
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State | TX
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Zip | 77707
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Country | US
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Telephone | 409-835-7676
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Fax | 409-835-5106
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | WILLIAM L DENMAN
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Credential | DC
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Telephone | 409-835-7676
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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 | 68562
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License Number State | TX
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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 | 6984
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License Number State | TX
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