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General NPI Number Information
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NPI Number | 1750610135
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Entity Type | Organization
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Legal Business Name | J.G. GROUP L.L.C.
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Dates
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Enumeration Date | 12/15/2009
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Last Update Date | 12/15/2009
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Provider Practice Location Address
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Address Line | 8207 HUDSON AVE STE D
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City | LUBBOCK
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State | TX
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Zip | 79423-2805
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Country | US
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Telephone | 806-548-7247
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Fax | 806-771-9333
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Provider Business Mailing Address
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Address Line | 6507 6TH ST
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City | LUBBOCK
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State | TX
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Zip | 79416-3763
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Country | US
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Telephone | 806-548-7247
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Fax | 806-771-9333
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. MARTIN ASCENCION MUNOZ
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Credential | D.C.
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Telephone | 806-548-7247
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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 | 11021
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License Number State | TX
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