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General NPI Number Information
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NPI Number | 1831397371
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Entity Type | Organization
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Legal Business Name | SSC CHIROPRACTIC, P.A.
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Dates
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Enumeration Date | 07/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1212 N JOSEY LN SUITE 250
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City | CARROLLTON
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State | TX
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Zip | 75006-6140
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Country | US
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Telephone | 972-416-5873
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 112624
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City | CARROLLTON
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State | TX
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Zip | 75011-2624
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Country | US
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Telephone | 972-416-5873
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. SCOTT TAN VIET LAI
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Credential | D.C.
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Telephone | 972-416-5873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 9363
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License Number State | TX
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