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General NPI Number Information
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NPI Number | 1790362580
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Entity Type | Organization
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Legal Business Name | FT. WORTH REHABILITATION, INC.
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 3510 LUTHER LN
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City | GARLAND
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State | TX
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Zip | 75043-1416
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Country | US
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Telephone | 214-396-4488
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Fax | 888-389-8141
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Provider Business Mailing Address
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Address Line | PO BOX 497014
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City | GARLAND
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State | TX
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Zip | 75049-7014
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Country | US
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Telephone | 214-396-4488
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Fax | 888-389-8141
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Authorized Official
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Title or Position | MANAGER
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Name | DR. JEFF KING
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Credential | DC, OPA-C
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Telephone | 214-396-4488
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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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