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General NPI Number Information
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NPI Number | 1851647408
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Entity Type | Organization
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Legal Business Name | AUSTIN CHIROPRACTIC AND WELLNESS LTD LLP
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Dates
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Enumeration Date | 08/01/2012
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Last Update Date | 08/01/2012
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Provider Practice Location Address
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Address Line | 13740 N HIGHWAY 183 STE L4
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City | AUSTIN
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State | TX
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Zip | 78750-1884
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Country | US
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Telephone | 512-257-3627
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Fax | 512-257-9870
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Provider Business Mailing Address
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Address Line | 13740 N HIGHWAY 183 STE L4
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City | AUSTIN
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State | TX
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Zip | 78750-1884
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Country | US
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Telephone | 512-257-3627
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Fax | 512-257-9870
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TREVOR JOHN BOTTS
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Credential | D.C.
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Telephone | 512-257-3627
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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 | 11922
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License Number State | TX
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